TY  - JOUR
A1  - Gfrörer, Stefan
A1  - Theilen, Till-Martin
A1  - Fiegel, Henning C.
A1  - Esmaeili, Anoosh
A1  - Rolle, Udo
T1  - Comparison of outcomes between complete and incomplete congenital duodenal obstruction
T2  - World journal of gastroenterology
N2  - Background: Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes.
Aim: To quantify and compare the association between CCDO and ICDO with outcome parameters.
Methods: We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27; atresia type 1-3, annular pancreas) and ICDO (n = 23; annular pancreas, web, Ladd´s bands).
Results: In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%; CCDO vs ICDO, P < 0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P ≤ 0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P < 0.01).
Conclusion: CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding.
KW  - Congenital duodenal obstruction
KW  - Duodenal atresia
KW  - Duodenal stenosis
KW  - Prenatal ultrasonographic detection rate
KW  - Clinical presentation
KW  - Preoperative diagnostics
KW  - Adverse events
KW  - Outcome
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/50813
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-508133
SN  - 2219-2840
SN  - 1007-9327
N1  - Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licen ses/by-nc/4.0/
VL  - 25
IS  - 28
SP  - 3787
EP  - 3797
PB  - WJG Press
CY  - Beijing
ER  -