Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome

Brian J. Pottorf, Farah Husain, H. Whitton Hollis, Edward Lin

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

IMPORTANCE Duodenal obstruction by compression from the superior mesenteric artery (SMA) can be managed using minimally invasive techniques initially developed for bariatric patients requiring gastric bypass.

OBSERVATIONS This retrospective review evaluates 12 patients with SMA syndrome who were treated with laparoscopic enteric bypass. Technical considerations are presented in detail. The study group comprised 5 men and 7 women, with ages ranging from 21 to 65 years (mean, 36.8 years). Operative times ranged from 53 to 126 minutes (mean, 72.4 minutes). Mean length of hospital stay was 4.2 days (range, 3-7 days). Obstructive symptoms were improved or eliminated in 11 patients (92%). One patient required readmission for inadequate control of generalized abdominal pain. No patients in this series developed postoperative bowel obstruction, wound complications, or anastomotic leaks or died.

CONCLUSIONS AND RELEVANCE Laparoscopic duodenojejunostomy is safe and effective and should be considered the optimal treatment for patients presenting with duodenal obstruction from SMA syndrome. Advances in minimally invasive surgery have demonstrated the safety and low morbidity of laparoscopically created enteric anastomoses. The shorter hospital stay, low morbidity, and high success of laparoscopic enteric bypass make this approach favorable to traditional open techniques.

Original languageEnglish (US)
Pages (from-to)1319-1322
Number of pages4
JournalJAMA Surgery
Volume149
Issue number12
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

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Superior Mesenteric Artery Syndrome
Duodenal Obstruction
Length of Stay
Morbidity
Bariatrics
Patient Readmission
Anastomotic Leak
Superior Mesenteric Artery
Gastric Bypass
Minimally Invasive Surgical Procedures
Operative Time
Abdominal Pain
Safety
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome. / Pottorf, Brian J.; Husain, Farah; Hollis, H. Whitton; Lin, Edward.

In: JAMA Surgery, Vol. 149, No. 12, 01.12.2014, p. 1319-1322.

Research output: Contribution to journalArticle

Pottorf, Brian J. ; Husain, Farah ; Hollis, H. Whitton ; Lin, Edward. / Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome. In: JAMA Surgery. 2014 ; Vol. 149, No. 12. pp. 1319-1322.
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