Long-term results of surgical treatment for Crohn's disease of the duodenum

To assess the long-term results of surgery for duodenal Crohn's disease, 11 patients, ten surgically treated, have been followed an average of 13.9 years to assess 1) the need for further treatment of duodenal disease; 2) the activity of Crohn's disease in other areas of the gastrointestinal tract; and 3) their functional status based on the Karnofsky Performance Scale (KPS). Follow-up indicates that seven patients have required a total of ten further operations directly related to duodenal Crohn's disease. The indications for subsequent operations were 1) marginal ulceration; 2) obstruction at or in one limb of the gastrojejunostomy due to recurrent jejunal Crohn's disease or stricturing at the gastrojejunostomy; and 3) duodenal fistula. Eight of these 11 patients also required surgery for Crohn's disease in other areas of the gastrointestinal tract. Despite a high reoperative rate for Crohn's disease in both the duodenum and other areas of the gastrointestinal tract, functional results, as tested by the KPS, can be satisfactory if appropriate reoperative surgery is done.