关键词: 十二指肠, 消化道异物, 手术

Abstract: Objective  To summarize and share the clinical characteristics and surgical management of duodenal foreign bodies.
Methods  A retrospective analysis was performed on 27 cases from January 2008 to September 2020 of duodenal foreign bodies confirmed by preoperative plain abdominal X-ray,Computed Tomography and/or endoscopy.The cases underwent indicated surgery including duodenotomy,gastrotomy and jejunostomy.The operation time,blood loss,complications and length of hospital stay were documented as well.
Results  The types of duodenal foreign bodies mainly included vegetal digestive calculi in 10 cases(37%),toothpicks in 4 cases(15%),razor blades in 3 cases(12%).Among the 27 cases,16 cases were treated by duodenotomy,8 cases by gastrotomy and 3 cases by jejunostomy.Each type of surgery was suited for a specific location of duodenal foreign bodies.The mean operation time of duodenotomy was(144±57)min,with mean blood loss(112±105)ml and(13.4±19.0)d as length of hospital stay.Trends of decreasing were observed in both gastrotomy and jejunostomy with regard to either mean surgical duration,blood loss or length of hospital stay.The main complications were duodenal anastomotic leakage(1 case),pulmonary infection(2 cases),incision infection(2 cases),and re-laparotomy(1 case).
Conclusion  Duodenotomy is mainly used for foreign bodies in the horizontal part of duodenum,while gastrotomy and jejunostomy are suitable for foreign bodies in the segment from duodenal bulb to nearby descending part and ascending part of duodenum respectively.All three types of surgery are safe and reliable.In clinical practice,we should choose the operations according to the foreign body retention position.

Key words: duodenum, foreign body, surgery