Duodenal patch grafting

Loss of duodenal tissue around the pancreatic and common bile ducts presents a challenge to abdominal surgeons. Available methods to correct the problem include duodenojejunostomy, diamond duodenoplasty, serosal patching, mucosal pedicle patching from the ileum or jejunum, and gastric island patching. The choice of procedure must be tailored to the nature of the defect, the amount of tissue lost and the amount of peritoneal contamination. We believe that jejunal mucosal pedicle patching is a reasonable choice in most instances.