الإدارة الجراحية لمتلازمة الشريان المساريقي العلوي

References

DOI: 10.12998/wjcc.v11.i15.3369

• Surgical therapy, however, can be recommended if conservative therapies fail especially in elder patients with multiple abdominal operation histories, immobility (bed rest), long history of SMA syndrome and arteriosclerosis of SMA.
• Various surgical procedures include laparoscopic, laparotomic, or robotic gastrojejunostomy, gastroduodenostomy and duodenojejunostomy, Strong's procedure (a division of the ligament of Treitz), anterior transposition of the third part of duodenum, duodenal lowering, Ladd's procedure, and transabdominal duodenojejunostomy.
• Since 1998, when the first successful laparoscopic duodenojejunostomy was performed, most surgeons prefer laparoscopic duodenojejunostomy because of its safety and effectiveness (success rates: 80%-100%).
• Most recently, a new technique of endoscopic gastrojejunostomy (so called lumen-apposing metal stent) has also been reported in several case reports as a safe and effective therapeutic option.