There are various types of reconstruction of gastrointestinal continuity after gastric resection. It seems that insufficient attention has been paid to how the geometry and flow conditions affect the gastroduodenal system after distal gastric resection. Also, intraluminal pressure can be the dominant cause of duodenal suture dehiscence, but still many pathological mechanisms involved in this surgical problem remain unclear.
A research article to be published on April 28, 2009 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Filipovic from University of Kragujevac used computer simulation, which was based on a finite element method, to study flow and mixing in the duodenal junction after distal gastric resection and a Billroth 2 procedure.
Using the finite element method, two different Billroth 2 procedure cases (A and B) were modeled. Case A was defined with a shorter and almost straight duodenal section, while case B has a much longer and curved duodenal section. Velocity, pressure and food concentration distribution were determined and the numerical results were compared with experimental observations.
The pressure distribution obtained by numerical simulation was in the range of the recorded experimental results. They found that case A had a more favorable pressure distribution in comparison with case B. However, case B had better performance in terms of food transport because of more continual food distribution, as well as better emptying of the duodenal section. This study offers insight into the transport process within the duodenal stump section after surgical intervention, which can be useful for future patient-specific predictions of a surgical outcome.
Reference: Filipovic N, Cvetkovic A, Isailovic V, Matovic Z, Rosic M, Kojic M. Computer simulation of flow and mixing at the duodenal stump after gastric resection. World J Gastroenterol
2009; 15(16): 1990-1998
http://www.wjgnet.com/1007-9327/15/1990.asp
Correspondence to: Nenad Filipovic, Faculty of Mechanical Engineering, University of Kragujevac, S Janjica 6, Kragujevac 34000, Serbia. fica@kg.ac.rs
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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