New modification of the Albrecht–Staveley operation for treating aorto-mesenteric compression of the duodenum

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Abstract

Aorto-mesenteric compression of the duodenum (Wilkie syndrome, upper mesenteric artery syndrome) is one of the causes of chronic duodenal obstruction. This condition is caused by compression of the horizontal branch of the duodenum between the abdominal aorta and the superior mesenteric artery, departing from the aorta at an acute angle. Among the causes of this pathological condition, an asthenic physique, pronounced weight loss in a short period of time, and others are distinguished. Currently, the main component of eliminating aorto-mesenteric compression is surgical intervention. Among other surgical methods, the most optimal is duodeno-jejunostomy according to Albrecht–Staveley. However, when this surgical intervention is associated with a high risk of developing a ‘vicious circle’ syndrome. The developed modification of the Albrecht–Staveley operation aims to minimize the risks of developing the ‘vicious circle’ syndrome.

About the authors

Badri V. Sigua

North-Western State Medical University named after I.I. Mechnikov

Email: dr.sigua@gmail.com
ORCID iD: 0000-0002-4556-4913
SPIN-code: 5571-8893

Doctor of Medical Sciences, Professor, Department of Faculty Surgery I.I. Grekova

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

Vyacheslav P. Zemlyanoy

North-Western State Medical University named after I.I. Mechnikov

Email: zeml.spb@mail.ru
ORCID iD: 0000-0003-2329-0023

doctor of medical sciences Professor, Head of the Department of Faculty Surgery. I.I. Grekova, Dean of the Department of Surgery

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

Andrey S. Kachiuri

North-Western State Medical University named after I.I. Mechnikov

Email: Kachiuria@mail.ru

surgeon of the surgical department №2

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

Kirill V. Fetisov

North-Western State Medical University named after I.I. Mechnikov

Email: kirill.fetisov@szgmu.ru

Candidate of Medical Sciences, Associate Professor of the Department of Faculty Surgery named after I.I. Grekova

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

Evgeni A. Zakharov

North-Western State Medical University named after I.I. Mechnikov

Email: dr.zakharovea@gmail.com
ORCID iD: 0000-0002-2070-7420

Clinical intern 2 years of the Department of Faculty Surgery. I.I. Grekova

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

Vyacheslav A. Melnikov

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: melnikov.szgmu@yandex.ru
ORCID iD: 0000-0002-9723-0392
SPIN-code: 2793-3016

Clinical intern 2 years of the Department of Faculty Surgery. I.I. Grekova

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

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Supplementary files

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2. Fig. 1. The “vicious circle” syndrome after the formation of duodenojejunal anastomosis

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3. Fig. 2. CT-picture of abdominal organs with contrast (the angle of superior mesenteric artery discharge from the aorta is shown)

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4. Fig. 3. Duodeno-jejunostomy according to Albrecht–Stavely with a plug according to Shalimov (diagram)

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5. Fig. 4. Duodeno-jejunostomy according to Albrecht–Stavely (a) with a plug according to Shalimov (b)

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Copyright (c) 2020 Sigua B.V., Zemlyanoy V.P., Kachiuri A.S., Fetisov K.V., Zakharov E.A., Melnikov V.A.

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