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Treatment

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Excision of a duodenal diverticulum seems like the most rational treatment, but it is associated with a high rate of mortality due to the formation of fistulae and pancreatic damage. The alternative is an anterior duodenotomy, invagination of the diverticulum, and excising from within.

Bypass procedures are safer than excision, but the long-term results may not be as good:

  • for bile:
    • choledochoduodenostomy
    • choledochojejunostomy-en-Y
  • for food, divide the duodenum beyond the pylorus, close the distal duodenal stump and restore continuity with either a:
    • gastrojejunostomy, or a
    • duodenojejunostomy

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