gastrojejenostomy

BACKGROUND: The first total laparoscopic pancreaticoduodenectomy was performed in 1994 by Gagner and Pomp. Their comments coupled with the inherent technical difficulties stifled development of the technique. In the last decade there has been a renewed interest in the technique with high volume centres publishing large series. We present our experience with the first operation completed at Dr George Mukhari Academic Hospital. METHOD: Pre-operative CT confirmed a resectable head of pancreas mass...

BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...

Incomplete vagotomy is the single most common cause of ulcer recurrence. Completeness of vagotomy was assessed postoperatively in 17 patients using the congo red test. Various types of vagotomies included truncal vagotomy and gastrojejenostomy in 6, highly selective vagotomy in 5, truncal vagotomy and pyloroplasty in 3 and selective vagotomy with gastrojejenostomy in 3 cases. Congo red test was positive in 13 cases, with 9 of these showing evidence of incomplete vagotomy manifesting as erosions, duodenitis, stomal ulceration or ulcer recurrence...