古市　好宏
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Morphological study of the gastrointestinal tract around the ligament of Treitz using upper gastrointestinal radiography: Fundamental data for EUS-guided gastrojejunostomy.
Journal Formal name：Journal of hepato-biliary-pancreatic sciences
Abbreviation：J Hepatobiliary Pancreat Sci
ISSN code：18686982/18686974
Domestic / ForeginForegin
Volume, Issue, Page 28(11),pp.1023-1029
Author and coauthor Nutahara Daisuke, Nagai Kazumasa, Sofuni Atsushi, Tsuchiya Takayoshi, Ishii Kentaro, Furuichi Yoshihiro, Kitamura Katsuya, Itoh Masahiro, Miyazawa Hideaki, Itoi Takao
Publication date 2021/11
Summary BACKGROUND/PURPOSE:We developed EUS-guided double-balloon occluded gastrojejunostomy (EPASS) for gastric drainage tract obstruction. The success of EPASS depends on the proximity of the stomach and the gastrointestinal (GI) tract near the ligament of Treitz. The aim of this study is to clarify the GI anatomy near the ligament of Treitz.METHODS:One thousand and sixteen cases imaged upper GI radiography using barium were retrospectively evaluated. Morphologically, the GI tract running near the ligament of Treitz was divided in three types: Type I: The 4th portion of the duodenum (D4) approaches the stomach; Type II: D4 does not approach the stomach; Type III: D4 forms a loop to the jejunum. The minimum distance between the stomach and the GI tract near the ligament of Treitz was measured.RESULTS:Based on the morphological classification, 74.6% in the study group was classified in Type I, 22.0% in Type II, and 3.3% in Type III, respectively. The median minimum distance in Type II/III group were significantly longer, compared with the Type I (P < .01).CONCLUSIONS:The GI anatomy near the ligament of Treitz was clarified using upper GI radiography. It is divided into three patterns, and one-fourth of cases may have difficulty in EUS-guided gastrojejunostomy.
DOI 10.1002/jhbp.1018
PMID 34181825