Duodenojejunostomy versus Duodenoduodenostomy in Congenital Duodenal Obstruction: A retrospective study

Congenital duodenal obstruction (CDO) is a common cause of neonatal intestinal obstruction, most requiring surgery to restore bowel continuity. Duodenoduodenostomy (DD) is the preferred procedure, but duodenojejunostomy (DJ) may be performed when DD is not feasible due to anatomy, particularly in small or premature infants. In our centre, choice of procedure was based on intraoperative findings, tension-free anastomosis feasibility, and surgeon preference. This study compared short-term outcomes of DJ and DD in CDO.

This is a retrospective study with a cross-sectional about outcome of congenital duodenal obstruction at Hasan Sadikin Bandung General Hospital in 2019-2024. Data were collected through medical records, including gestational age, age at surgery, surgical technique, operation time, time to first feed, time to full feed, length of stay, and mortality.

There were a total of 36 congenital duodenal obstruction patients. There were 4 patients (11%) who died before surgery, and 32 patients (89%) underwent surgery. All procedures were performed open surgery. Duodenojejunostomy was performed in 10 patients (31%), duodenoduodenostomy in 22 patients (69%). Time to first feed (mean) is post operative day 8 vs 9 (P = 0.3), time to full feed (mean) post operative day 27.1 vs 25.4 (p=0.8) and length of stay (mean) 27.6 days vs 34.6 days (p=0.9). Three patient of each group died post operative due to sepsis.

Duodenojejunostomy and duodenoduodenostomy have similar outcomes in neonates with congenital duodenal obstruction. These findings are relevant for surgeons who repair congenital duodenal obstruction with duodenojejunostomy or duodenoduodenostomy in open surgery.