{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:35:16Z","timestamp":1747226116071,"version":"3.40.5"},"reference-count":0,"publisher":"Galenos Yayinevi","issue":"2","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turk J Surg"],"accepted":{"date-parts":[[2024,6,27]]},"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> The aim of this study was to investigate the surgical treatment methods and outcomes of difficult duodenal defects due to perforation.<\/jats:p>\n                    <jats:p><jats:bold>Material and Methods:<\/jats:bold> Data of patients who had undergone surgery for difficult duodenal defect between January 2012 and November 2022 were collected. Duodenal defect size of 2 cm or more was defined as difficult duodenal defect. Characteristics of the patients, the etiology of perforation, American Society of Anesthesiology (ASA) scores, Mannheim peritonitis index (MPI), surgical treatment, need for re-operation, and morbidity and mortality were evaluated.<\/jats:p>\n                    <jats:p><jats:bold>Results:<\/jats:bold> Nineteen patients were detected. Etiology was peptic ulcer perforation in 12 (63.1%) patients, aortaduodenal fistula in 2 (10.5%), tumor implant in 2 (10.5%), cholecystoduodenal fistula in 1 (5.2%), endoscopic retrograde cholangio pancreatography (ERCP) in 1 (5.2%), and cholecystectomy related injury in 1 (5.2%) patient. The first surgical procedure was duodenoraphy + omentopexy in 8 (42.1%), Graham repair in 5 (26.3%), duodenal segment 3-4 resection and Roux-en-Y side to side duodenojejunostomy in 4 (21.0%), Roux-en-Y side to side duodenojejunostomy in 1 (0.5%), and 1 (0.5%) subtotal gastrectomy + duodenum 1<jats:sup>st<\/jats:sup> part resection + Roux-en-Y gastroenterostomy, cholecystectomy and external biliary drainage via cystic duct. Four patients who had previously undergone Graham repair (3) and duodenoraphy + omentopexy (1) required salvage surgery. As a salvage surgery; 1 end-to-side and 3 side-to-side Roux-en-Y duodenojejunostomies were performed. Overall, mortality occurred in 6 (31.6%) patients. High ASA score and MPI were considered as significant risk factors for mortality (p= 0.015, p= 0.002).<\/jats:p>\n                    <jats:p><jats:bold>Conclusion:<\/jats:bold> Primary repair techniques can be used in the surgical treatment of difficult duodenal defects when peritonitis is not severe and tensionfree repair is possible. Otherwise, duodenojejunostomy may be preferred as a fast, easy, and safe technique for both initial and salvage surgeries.<\/jats:p>","DOI":"10.47717\/turkjsurg.2024.6476","type":"journal-article","created":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T08:26:21Z","timestamp":1719649581000},"page":"161-167","source":"Crossref","is-referenced-by-count":0,"title":["How to manage difficult duodenal defects? Single center experience"],"prefix":"10.47717","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-8630","authenticated-orcid":false,"given":"Tufan","family":"Egeli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5227-5514","authenticated-orcid":false,"given":"\u00d6zg\u00fcr","family":"\u00c7avdaro\u011flu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9848-0326","authenticated-orcid":false,"given":"Cihan","family":"A\u011falar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2828-1452","authenticated-orcid":false,"given":"Serhan","family":"Derici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-6819","authenticated-orcid":false,"given":"S\u00fcleyman","family":"Aksoy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7498-9531","authenticated-orcid":false,"given":"\u0130nan","family":"Y\u0131lmaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3217-9485","authenticated-orcid":false,"given":"Ali Durubey","family":"\u00c7evlik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7040-4228","authenticated-orcid":false,"given":"Tayfun","family":"Bi\u015fgin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4755-2200","authenticated-orcid":false,"given":"Berke","family":"Mano\u011flu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7444-0434","authenticated-orcid":false,"given":"M\u00fccahit","family":"\u00d6zbilgin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6235-9903","authenticated-orcid":false,"given":"Tarkan","family":"\u00dcnek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2811","published-online":{"date-parts":[[2024,6,28]]},"container-title":["Turkish Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/turkjsurg.com\/full-text-pdf\/1974\/eng","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/turkjsurg.com\/full-text-pdf\/1974\/eng","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T06:07:50Z","timestamp":1741068470000},"score":1,"resource":{"primary":{"URL":"https:\/\/turkjsurg.com\/articles\/doi\/turkjsurg.2024.6476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,6,1]]}},"URL":"https:\/\/doi.org\/10.47717\/turkjsurg.2024.6476","relation":{},"ISSN":["2564-6850","2564-7032"],"issn-type":[{"type":"print","value":"2564-6850"},{"type":"electronic","value":"2564-7032"}],"subject":[],"published":{"date-parts":[[2024,6,1]]}}}