Comparison of outcomes between complete and incomplete congenital duodenal obstruction

  • 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.

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Author:Stefan Gfrörer, Till-Martin Theilen, Henning C. Fiegel, Anoosh Esmaeili, Udo RolleORCiDGND
Pubmed Id:
Parent Title (English):World journal of gastroenterology
Publisher:WJG Press
Place of publication:Beijing
Contributor(s):Yan-Liang Zhang, Yun-Xiaojian Wu
Document Type:Article
Year of Completion:2019
Date of first Publication:2019/07/28
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/08/26
Tag:Adverse events; Clinical presentation; Congenital duodenal obstruction; Duodenal atresia; Duodenal stenosis; Outcome; Prenatal ultrasonographic detection rate; Preoperative diagnostics
Page Number:16
First Page:3787
Last Page:3797
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: ses/by-nc/4.0/
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0