PMC6038102_01
Laparostomy and pyloroduodenostomy of the first (DI) and second (DII) duodenal parts.
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(A-C) Antrectomy and duodenectomy of DI and duodenectomy of the suprapapillary part of DII; (D,E) gastrojejunostomy (end-to-side), duodenojejunostomy (DII and DIII) side-to-side at 40 cm of the gastrojejunal anastomosis, and jejunojejunostomy.
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Four months later at our Hospital the following surgical procedures were performed: circumferential para-celiostomic incision in a non-inflamed tissue; extensive lysis of dense intestinal adhesions; dissection and identification of the gastric antrum and antrectomy; dissection and identification of the first (DI) and second (DII) duodenal parts; duodenectomy of DI and duodenectomy of the suprapapillary part of DII; gastrojejunostomy (end-to-side) (T-L); duodenojejunostomy (DII and DIII) side-to-side (L-L) at 40 cm of the gastrojejunal anastomosis; jejunojejunostomy T-L (Fig. 2).
(A-C) Abdominal Wall plasty with a Proceed  mesh. (D) Primary cutaneous suture and multitubular drain near duodenal anastomosis and subcutaneous suction drainage. (E,F) Postoperative subcutaneous seroma. (G) The patient was discharged at the 60th postoperative day.
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Multitubular drain near the duodenal anastomosis and subcutaneous suction drainage were set (Fig. 3). The patient was discharged at the 60th postoperative day with a weight gain of 10 kg (Fig. 3).