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International Journal of Pediatrics
Volume 2009, Article ID 175963, 5 pages
Clinical Study

The Modified Kimura's Technique for the Treatment of Duodenal Atresia

1Pediatric and Neonatal Surgery Unit, Department of Medical and Surgical Pediatrics, University of Messina, Policlinico Universitario G. Martino, Viale Gazzi 1, 98100 Messina, Italy
2Department of Anesthesiology and Intensive Care, University of Messina, 98100 Messina, Italy

Received 27 November 2008; Accepted 31 March 2009

Academic Editor: Kannan Laksmi Narasimhan

Copyright © 2009 Biagio Zuccarello et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background/Purpose. Kimura's diamond-shaped-duodenoduodenostomy (DSD) is a known technique for the correction of congenital intrinsic duodenal obstruction. We present a modification of the technique and review the advantages of this new technique. Methods. From 1992 to 2006, 14 newborns were treated for duodenal atresia. We inverted the direction of the duodenal incisions: a longitudinal incision was made in the proximal duodenum while the distal was opened by transverse incision. Results. Our “inverted-diamond-shaped-duodenoduodenostomy” (i-DSD) allowed postoperative oral feeding to start on days 2 to 3, peripheral intravenous fluids discontinuity on days 3 to 8 (median values 3.6); time to achieve full oral feeds on days 8 to 12 (median values 9.4); the length of hospitalisation ranged from 10 and 14 days (median value 11.2). No complications related to the anastomosis, by Viz leakage, dehiscence, biliary stasis, or stenosis were observed. Conclusions. The i-DSD provides a safe procedure to protect the ampulla of Vater from injury and avoids any formation of a blind loop. The results show that patients who have i-DSD achieve full oral feeds in a very short time period and, consequently, the length of hospitalisation is also significantly reduced.