[Characteristics of surgical sutures in the duodenum and small intestine]

The particularities of the surgical suture of duodenum and small intestine are exposed. According to the recent experiences from the literature, the best material for the intestinal suture is monofilamentous, with delayed resorption rate, and characterized by the hardness appropriate to the tissue involved. The representatives of these are Polyglactin and Polydioxanon. In the technique of the duodenal suture, inversion of the tissue and placing the sutures in the healthy tissue are more important than mucosal inversion and multiple layers closure. The omental patch must be variable, and not involved directly in sutures. In the small intestinal surgery, one layer sero muscular-extramucosal, or two layers mucomucosal with inversion and seroserosal suture are to be used. For duodenojejunal transition, terminolateral anastomosis is recommendable. Upon lower parts of ileum oblique terminoterminal or latero-lateral anastomosis is to be used. In the cases of luminal disproportion between open ends, terminolateral anastomosis seems to be the best choice. The percentage of duodenal stump dehiscence in the period of 1986-1992. is 2.53% upon 356 emergencies of delayed operations, and the percentage of the intestinal anastomotic dehiscence upon 102 elective and emergency operations is 5.8%.