Jeffrey C Lawrence1, Salim Hosein, MD2, James B Wooldridge, MD, FACS2, William S Richardson, MD, FACS2. 1University of Queensland Medical School – Ochsner Clinical School, 2Ochsner Clinic Foundation
Background: Laparoscopic management of jejuno-jejunal (JJ) intussusception is an accepted approach to JJ after gastric bypass for weight loss. Typically this occurs from distally through the JJ into biliopancreatic limb (BPL). We show the results of our operative technique of decreasing the size of the JJ anastomosis utilizing a laparoscopic linear stapler.
Methods: Retrospective review of EMR data from 2015 for patients presenting of operatively managed cases of JJ intussusception identified by CPT codes. All patients had intermittent abdominal pain and intussusception on CT.
Results: 3 cases were identified. 2 were started laparoscopically and one was converted due to adhesions to the abdominal wall. One was started open (due to known adhesions). Operative approach was reduction of intussusception, linear stapling of the JJ along the prior staple line to reduce anastamotic size and tacking the BPL to the distal small bowel (only the last 2 patients). There were no complications and no morbidity. Follow up visits at 2 weeks, 1 month, and 1 year confirmed no recurrent intussusceptions and abdominal pain related to incidences of intussusception was resolved.
Conclusion: Laparoscopic approach to JJ intussusceptions is not always possible. Complete redo of JJ anastamosis may not be necessary and simple partial division of the JJ anastamosis with or without tacking of the distal limb to the biliopancreatic limb may decrease complication rates.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79843
Program Number: P568
Presentation Session: Poster (Non CME)
Presentation Type: Poster
