PMC3015298_01
Trocar insertion sites for performance of a laparoscopic duodenojejunostomy. The right paramedian trocar was inserted first utilizing an open procedure, due to a previous midline incision.
jsls-2-3-281-g01.jpg
PMC3015298_01_jsls-2-3-281-g01.jpg
F1
As the intra-abdominal adhesions were cleared, three additional trocars were placed, one each in the left lateral abdomen, xiphoid, and at the umbilicus (Figure 1).
Creation of a laparoscopic duodenojejunostomy utilizing a 35 mm GIA stapler (United States Surgical Corporation, Norwalk, CT).
jsls-2-3-281-g02.jpg
PMC3015298_01_jsls-2-3-281-g02.jpg
F2
After performance of an anti-mesenteric jejunotomy, a 35 mm GIA (United States Surgical Corporation, Norwalk, CT) was introduced into both lumens and a duodenojejunostomy was created (Figure 2).
Upper gastrointestinal series demonstrating a patent duodenojejunostomy with flow of contrast past the stapled anastomosis.
jsls-2-3-281-g03.jpg
PMC3015298_01_jsls-2-3-281-g03.jpg
F3
A gastrograffin study obtained on postoperative day 2 demonstrated free flow of contrast through the duodenojejunostomy (Figure 3).