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BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report

INTRODUCTION: Very-short proximal jejunal stump anastomosis leak has been a major problem in surgery and it causes high postoperative morbidity and mortality. However, using a Bishop-Koop Modification technique anastomosis with decompression and nutrition tube, we can completely cure the patient wit...

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Autores principales: Budipramana, Vicky S., Saraswati, Putu Ayu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326990/
https://www.ncbi.nlm.nih.gov/pubmed/32637085
http://dx.doi.org/10.1016/j.amsu.2020.06.027
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author Budipramana, Vicky S.
Saraswati, Putu Ayu
author_facet Budipramana, Vicky S.
Saraswati, Putu Ayu
author_sort Budipramana, Vicky S.
collection PubMed
description INTRODUCTION: Very-short proximal jejunal stump anastomosis leak has been a major problem in surgery and it causes high postoperative morbidity and mortality. However, using a Bishop-Koop Modification technique anastomosis with decompression and nutrition tube, we can completely cure the patient with this case. PRESENTATION OF CASE: A 61-year-old man came to the emergency room with generalized peritonitis and sepsis, on emergency laparotomy we found a perforation from solid tumor located in the proximal jejunum, 20 cm distal to ligament of Treitz. Free purulent exudate and diffuse inflammatory reaction of the peritoneum were also found in the abdominal cavity. We resected the jejunum together with the mass and anastomosis using Bishop-Koop technique with the decompression and nutrition tube. The patient completely recovered and left the hospital after a total stay of 30 days. DISCUSSION: Surgery-associated-anastomotic leak has been a major complication in performing anastomosis on the very-proximal jejunum especially in septic condition. The decompression after anastomosis is important, because of the high excretion of Brunner gland, bile, pancreas, duodenum, and jejunum juice and also the paralytic bowel condition in septic condition can make fluid accumulation in jejunum. It was impossible to decompress the anastomosis by performing an external jejunostomy because the proximal stump was too close to the ligament of Treitz. Using Bishop-Koop anastomosis technique, we were able to decompress the anastomosis and to give early nutrition using tubes at the same time. CONCLUSION: Bishop-Koop anastomosis modification with decompression and nutrition tube is a safe procedure for anastomosing on the very-proximal jejunum.
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spelling pubmed-73269902020-07-06 BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report Budipramana, Vicky S. Saraswati, Putu Ayu Ann Med Surg (Lond) Case Report INTRODUCTION: Very-short proximal jejunal stump anastomosis leak has been a major problem in surgery and it causes high postoperative morbidity and mortality. However, using a Bishop-Koop Modification technique anastomosis with decompression and nutrition tube, we can completely cure the patient with this case. PRESENTATION OF CASE: A 61-year-old man came to the emergency room with generalized peritonitis and sepsis, on emergency laparotomy we found a perforation from solid tumor located in the proximal jejunum, 20 cm distal to ligament of Treitz. Free purulent exudate and diffuse inflammatory reaction of the peritoneum were also found in the abdominal cavity. We resected the jejunum together with the mass and anastomosis using Bishop-Koop technique with the decompression and nutrition tube. The patient completely recovered and left the hospital after a total stay of 30 days. DISCUSSION: Surgery-associated-anastomotic leak has been a major complication in performing anastomosis on the very-proximal jejunum especially in septic condition. The decompression after anastomosis is important, because of the high excretion of Brunner gland, bile, pancreas, duodenum, and jejunum juice and also the paralytic bowel condition in septic condition can make fluid accumulation in jejunum. It was impossible to decompress the anastomosis by performing an external jejunostomy because the proximal stump was too close to the ligament of Treitz. Using Bishop-Koop anastomosis technique, we were able to decompress the anastomosis and to give early nutrition using tubes at the same time. CONCLUSION: Bishop-Koop anastomosis modification with decompression and nutrition tube is a safe procedure for anastomosing on the very-proximal jejunum. Elsevier 2020-06-24 /pmc/articles/PMC7326990/ /pubmed/32637085 http://dx.doi.org/10.1016/j.amsu.2020.06.027 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Budipramana, Vicky S.
Saraswati, Putu Ayu
BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report
title BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report
title_full BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report
title_fullStr BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report
title_full_unstemmed BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report
title_short BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report
title_sort bishop–koop modification technique following proximal jejunal anastomosis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326990/
https://www.ncbi.nlm.nih.gov/pubmed/32637085
http://dx.doi.org/10.1016/j.amsu.2020.06.027
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