{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:55:57Z","timestamp":1774882557252,"version":"3.50.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Barnett continent reservoir has long been used as a surgical option for patients requiring continent ileostomies, but complications such as valve leakage, obstruction, and pouch failure often necessitate revisions. Conversion to a Kock (K) pouch offers an alternative with potentially improved outcomes. This study evaluated the safety (postoperative complications), feasibility (technical completion of conversion), and effectiveness (long-term pouch salvage) of conversion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients who underwent Barnett-to-K-pouch conversion (conversion group) or remained with a Barnett pouch (non-conversion group) between 1991 and April 2024. The conversion technique included disconnection of the afferent limb, preservation and 180\u00b0 rotation of the reservoir, resection of the collar valve, creation of a stapled nipple valve, and pouch\u2013neo-afferent limb anastomosis. Demographics, surgical history, and long-term follow-up were collected. Pouch salvage was defined as retention of a functional continent pouch; failure was defined as excision with permanent ileostomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 30 patients with Barnett pouch patients included, 16 underwent conversion and 14 did not. Median age was 51.5 versus 60.5\u00a0years, and median body mass index (BMI) was 24.7 versus 22.3\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      in conversion versus non-conversion groups, respectively. Ulcerative colitis was the primary indication (62.6% versus 78.8%). Leading revision causes were valve slippage (50% versus 35.7%) and fistula (18.7% versus 28.6%). Pouch salvage was higher with conversion (81.3%, 95% confidence interval [CI] 54\u201396%) versus non-conversion (35.7%, 95% CI 13\u201365%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Long-term follow-up (median: 159.5 versus 301.6\u00a0months,) showed that 60% of all patients in conversion group retained continent pouches, while the remaining experienced pouch excision, indicating an overall failure rate of 40%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Conversion of Barnett to K-pouch improves pouch salvage and reduces failure. While technically complex, the procedure can be safely offered to motivated patients seeking to avoid permanent ileostomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-026-03310-y","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:15:42Z","timestamp":1774628142000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Conversion of Barnett continent reservoir to Kock reservoir: A 30-year retrospective study on surgical outcomes and long-term follow-up"],"prefix":"10.1007","volume":"30","author":[{"given":"A.","family":"Alipouriani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. C.","family":"Duraes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Liska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. D.","family":"Holubar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. R.","family":"Steele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Lavryk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"issue":"8","key":"3310_CR1","first-page":"290","volume":"115","author":"A Schaudig","year":"1973","unstructured":"Schaudig A, Kock N, von Bary S, Nakano H (1973) [Kock\u2019s continent ileostomy]. Munch Med Wochenschr 115(8):290\u2013295","journal-title":"Munch Med Wochenschr"},{"issue":"10","key":"3310_CR2","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1097\/00007611-198710000-00016","volume":"80","author":"WO Barnett","year":"1987","unstructured":"Barnett WO (1987) Continent intestinal reservoir. South Med J 80(10):1262\u20131265","journal-title":"South Med J"},{"issue":"1","key":"3310_CR3","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1055\/s-2008-1055323","volume":"21","author":"DE Beck","year":"2008","unstructured":"Beck DE (2008) Continent ileostomy: current status. Clin Colon Rectal Surg 21(1):62\u201370","journal-title":"Clin Colon Rectal Surg"},{"issue":"27","key":"3310_CR4","doi-asserted-by":"publisher","first-page":"3479","DOI":"10.3748\/wjg.v18.i27.3479","volume":"18","author":"G Nessar","year":"2012","unstructured":"Nessar G, Wu JS (2012) Evolution of continent ileostomy. World J Gastroenterol 18(27):3479\u20133482","journal-title":"World J Gastroenterol"},{"issue":"9","key":"3310_CR5","doi-asserted-by":"publisher","first-page":"2286","DOI":"10.1111\/codi.15788","volume":"23","author":"M Deputy","year":"2021","unstructured":"Deputy M, Worley G, Patel K, Fletcher J, Hart A, Block M et\u00a0al (2021) Long-term outcome and quality of life after continent ileostomy for ulcerative colitis: a systematic review. Colorectal Dis 23(9):2286\u20132299","journal-title":"Colorectal Dis"},{"issue":"1","key":"3310_CR6","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s10151-024-03018-x","volume":"28","author":"SH Emile","year":"2024","unstructured":"Emile SH, Garoufalia Z, Mavrantonis S, Rogers P, Barsom SH, Horesh N et\u00a0al (2024) Complications and failure after Kock continent ileostomy: a systematic review and meta-analysis. Tech Coloproctol 28(1):135","journal-title":"Tech Coloproctol"},{"issue":"6","key":"3310_CR7","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1055\/s-0042-1758192","volume":"35","author":"R Shuford","year":"2022","unstructured":"Shuford R, Ashburn JH (2022) Don\u2019t forget about the K-pouch! Clin Colon Rectal Surg 35(6):499\u2013504","journal-title":"Clin Colon Rectal Surg"},{"issue":"4","key":"3310_CR8","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/DCR.0000000000001823","volume":"64","author":"A Risto","year":"2021","unstructured":"Risto A, Hallb\u00f6\u00f6k O, Andersson P, Sj\u00f6dahl R, Myrelid P (2021) Long-term follow-up, patient satisfaction, and quality of life for patients with Kock\u2019s continent ileostomy. Dis Colon Rectum 64(4):420\u2013428","journal-title":"Dis Colon Rectum"},{"issue":"11","key":"3310_CR9","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1097\/DCR.0000000000002517","volume":"66","author":"A Risto","year":"2023","unstructured":"Risto A, Andersson RE, Landerholm K, Bengtsson J, Block M, Myrelid P (2023) Reoperations and long-term survival of Kock\u2019s continent ileostomy in patients with IBD: a population-based national cohort study from Sweden. Dis Colon Rectum 66(11):1492\u20131499","journal-title":"Dis Colon Rectum"},{"issue":"4","key":"3310_CR10","first-page":"403","volume":"87","author":"J Kameyama","year":"1986","unstructured":"Kameyama J, Hoshikawa T, Tsukamoto M, Sasaki I, Narui H, Funayama Y et\u00a0al (1986) Surgical problems of Kock\u2019s continent ileostomy in patients with ulcerative colitis. Nihon Geka Gakkai Zasshi 87(4):403\u2013407","journal-title":"Nihon Geka Gakkai Zasshi"},{"issue":"1","key":"3310_CR11","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-023-04555-x","volume":"38","author":"NKJ Ecker","year":"2023","unstructured":"Ecker NKJ, Dinh C, M\u00f6slein G, Ecker KW (2023) Comparing continent ileostomy (CI) conversion to repair\/redo IPAA: favorable outcomes. Int J Colorectal Dis 38(1):261","journal-title":"Int J Colorectal Dis"},{"issue":"5","key":"3310_CR12","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1111\/codi.16064","volume":"24","author":"KW Ecker","year":"2022","unstructured":"Ecker KW, Dinh C, Ecker NKJ, M\u00f6slein G (2022) Conversion of ileo-pouch anal anastomosis to continent ileostomy: strategic surgical considerations and outcome. Colorectal Dis 24(5):631\u2013638","journal-title":"Colorectal Dis"},{"issue":"S1","key":"3310_CR13","first-page":"S26","volume":"65","author":"A Angistriotis","year":"2022","unstructured":"Angistriotis A, Shen B, Kiran RP (2022) Construction of and conversion to continent ileostomy: a systematic review. Dis Colon Rectum 65(S1):S26-s36","journal-title":"Dis Colon Rectum"},{"issue":"3","key":"3310_CR14","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1097\/DCR.0000000000002619","volume":"66","author":"LC Duraes","year":"2023","unstructured":"Duraes LC, Holubar SD, Lipman JM, Hull TL, Lightner AL, Lavryk OA et\u00a0al (2023) Redo continent ileostomy in patients with IBD: valuable lessons learned over 25 years. Dis Colon Rectum 66(3):419\u2013424","journal-title":"Dis Colon Rectum"}],"container-title":["Techniques in Coloproctology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10151-026-03310-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-026-03310-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-026-03310-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:08:10Z","timestamp":1774879690000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10151-026-03310-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["3310"],"URL":"https:\/\/doi.org\/10.1007\/s10151-026-03310-y","relation":{},"ISSN":["1123-6337","1128-045X"],"issn-type":[{"value":"1123-6337","type":"print"},{"value":"1128-045X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"assertion":[{"value":"11 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"SDH has received consulting fees from Takeda and a recipient of Crohn\u2019s & Colitis Foundation and American Society of Colorectal Surgeons grants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the institutional review board. Given the retrospective nature and no contact made with the patients the consent was waived.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and Informed Consent"}}],"article-number":"49"}}