Modified Paul-Mikulicz jejunostomy in frail geriatric patients undergoing emergency small bowel resection.
Journal
Minerva chirurgica
ISSN: 1827-1626
Titre abrégé: Minerva Chir
Pays: Italy
ID NLM: 0400726
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
pubmed:
26
5
2018
medline:
7
11
2019
entrez:
26
5
2018
Statut:
ppublish
Résumé
Proximal or extended bowel resections are sometimes necessary during emergency surgery of the small bowel and call for creating a high small bowel stomy as a part of damage control surgery. Secondary restoration of intestinal continuity in the frail geriatric patient, further weakened by subsequent severe malabsorption may be prohibitive. Six patients underwent emergency small bowel resection for proximal jejunal disease (83.3% high-grade adhesive SBO and 16.7% jejunal diverticulitis complicated with perforation). With the intention to avoid end jejunostomy and the need for repeat laparotomy for bowel continuity restoration we modified the classic Paul-Mikulicz jejunostomy. The postoperative course was uneventful in four patients whose general condition improved considerably. At six-month follow-up, neither patients required parenteral nutrition. This modified stoma can have the advantage of allowing a partial passage of the enteric contents, reducing the degree of malabsorption, and rendering jejunostomy reversal easy to perform later.
Sections du résumé
BACKGROUND
BACKGROUND
Proximal or extended bowel resections are sometimes necessary during emergency surgery of the small bowel and call for creating a high small bowel stomy as a part of damage control surgery. Secondary restoration of intestinal continuity in the frail geriatric patient, further weakened by subsequent severe malabsorption may be prohibitive.
METHODS
METHODS
Six patients underwent emergency small bowel resection for proximal jejunal disease (83.3% high-grade adhesive SBO and 16.7% jejunal diverticulitis complicated with perforation). With the intention to avoid end jejunostomy and the need for repeat laparotomy for bowel continuity restoration we modified the classic Paul-Mikulicz jejunostomy.
RESULTS
RESULTS
The postoperative course was uneventful in four patients whose general condition improved considerably. At six-month follow-up, neither patients required parenteral nutrition.
CONCLUSIONS
CONCLUSIONS
This modified stoma can have the advantage of allowing a partial passage of the enteric contents, reducing the degree of malabsorption, and rendering jejunostomy reversal easy to perform later.
Identifiants
pubmed: 29795063
pii: S0026-4733.18.07714-3
doi: 10.23736/S0026-4733.18.07714-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM