Computer simulation of flow and mixing at the duodenal stump after gastric resection

Abstract

AIM:To investigate the flow and mixing at the duodenal stump after gastric resection, a computer simulation was implemented. METHODS:Using the finite element method, two different Billroth Ⅱ 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. RESULTS:The pressure distribution obtained by numerical simulation was in the range of the recorded experimental results. 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. CONCLUSION: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.

A Nature‐Derived, Hetero‐Structured, Pro‐Healing Bioadhesive Patch for High‐Performance Sealing of Wet Tissues

“…In comparison, the average pressure in the small intestine is merely 0.40-0.53 kPa (3.5-4.5 mmHg). [58] These results further confirmed that the SSAD-Patch exhibited favorable adhesive abilities even under extreme conditions.…”

Two cases of a perforated duodenal diverticulum after gastrectomy with Roux-en-Y reconstruction

“…And, all of them were reconstructed by the Billroth II method. Using manometry equipment, Filipovic et al have reported that the intraluminal duodenal stump pressure after gastrectomy reconstructed by the Billroth II method, which forms a blind loop, was higher than that at the preoperative state [14]. Moreover, the longer afferent loop reportedly caused the increase in the intraduodenal stump pressure.…”

Duodenal Stump Blowout

“…Recent work using computerized manometry and mathematical models has demonstrated that the length of the afferent duodenal section associated with the duodenal stump has important implications for pressure distribution, food mixing, and appropriate transport [11]. Longer duodenal sections, while reducing the risk of retrograde food mixing in the direction of the stump, also led to higher stump pressures, with maximal pressure at the point of duodenal closure.…”