Surgical management of duodenal Crohn's disease

Table 1 Basic information, the primary site of lesion, and detailed information of surgical approaches of 16 patients with duodenal Crohn's disease

Classification	Sex	Age	Primary site	Manifestation	Surgical approach	Postoperative surgical recurrence
Primary	Female	29	Duodenum	Stricture	Duodenal bypass and gastrojejunostomy	No
	Female	35	Duodenum	Stricture	Duodenal bypass and gastrojejunostomy	No
	Female	30	Duodenum	Stricture	Duodenal bypass and gastrojejunostomy	No
	Male	20	Duodenum	Stricture	Duodenal bypass and gastrojejunostomy	No
	Male	25	Duodenum	Stricture	Duodenal bypass and gastrojejunostomy	No
	Male	29	Duodenum	Tumor-like	Pancreaticoduodenectomy	No
Secondary	Male	26	Ileocolon	Internal fistula (d = 0.3 cm)	Direct closure of the duodenal defect and right hemicolectomy	No
	Male	30	Ascending colon	Internal fistula (d = 1 cm)	Direct closure of the duodenal defect and subtotal colectomy	No
	Female	20	Right hemicolon	Internal fistula (d = 1 cm)	Direct closure of the duodenal defect and right hemicolectomy	No
	Male	37	Right hemicolon	Internal fistula (d = 5.0 cm)	Closure of duodenal defect with pedicled terminal ileum flap, right hemicolectomy	No
	Male	41	Right hemicolon	Internal fistula (d = 3.5 cm)	Closure of duodenal defect with pedicled terminal ileum flap, right hemicolectomy	No
	Male	32	Ascending colon	Internal fistula (d = 3.5 cm)	Closure of duodenal defect with pedicled terminal ileum flap and ascending colectomy	No
	Female	23	Right hemicolon	Without internal fistula	Duodenal lesion exclusion and right hemicolectomy	No
	Male	39	Ileocolon	Without internal fistula	Duodenal lesion exclusion and right hemicolectomy	No
	Male	32	Right hemicolon	Without internal fistula	Duodenal lesion exclusion and right hemicolectomy	No
	Male	36	Ileum	Without internal fistula	Duodenal lesion exclusion and double lumen ileostomy	No

“d” is the size of duodenal defect (cm).

Table 2 Montreal classification of patients with Crohn's disease (n = 16)

Item	Group	Frequency	Constituent ratio (%)
Diseased location (L)	L4: Upper gastrointestinal tract	6	38
	L1 + L4: Ileum + upper gastrointestinal tract	1	6
	L2 + L4: Colon + upper gastrointestinal tract	2	12
	L3 + L4: Ileocolon + upper gastrointestinal tract	7	44
Disease behavior (B)	B2: Stenotic type	9	56
	B2 + B3: Stenotic penetration type	7	44

Table 3 Results of laboratory examination and body mass index in patients with duodenal Crohn's disease before and after surgery

mean ± SD	Pre-operation	Post-operation
		Day 1	Day 3	Day 7	The 3rd month
WBC (× 109/L)	7.38 ± 4.44	16.36 ± 7.47	7.06 ± 2.36	5.56 ± 3.10	5.38 ± 1.09
NEUT%	67.32 ± 21.31	88.62 ± 4.06	74.11 ± 10.83	67.27 ± 12.37	67.44 ± 7.79
PLT (× 109/L)	394 ± 191.73	335 ± 181.17	273 ± 95.04	294 ± 96.90	253 ± 55.52
HGB (g/L)	107 ± 23.30	108 ± 27.61	100 ± 25.27	101 ± 21.16	128 ± 18.84
ESR (mm/h)	41.60 ± 30.59	20.50 ± 14.85	72.67 ± 27.15	22.00 ± 16.97	6.61 ± 4.22
CRP (mg/L)	34.56 ± 42.57	39.58 ± 23.74	85.47 ± 87.36	39.75 ± 38.52	1.91 ± 1.18
PCT (ng/mL)	0.07 ± 0.05	0.24 ± 0.24	1.52 ± 2.05	0.26 ± 0.14	0.02 ± 0.01
ALB (g/L)	31.31 ± 10.45	30.77 ± 6.48	32.11 ± 4.17	34.12 ± 4.53	41.71 ± 3.12
BMI (kg/m2)	15.90 ± 2.31	NA	NA	NA	20.83 ± 1.69

WBC: White blood count; CRP: C-reactive protein; BMI: Body mass index; NEUT: Neutrophil; PLT: Platelet count; HGB: Hemoglobin; ESR: Erythrocyte sedimentation rate; PCT: Procalcitonin; ALB: Albumin; NA: Not available.