Surgery Today

, Volume 45, Issue 1, pp 17–21 | Cite as

Laparoscopic diagnosis and treatment of neonates with duodenal obstruction associated with an annular pancreas: report of 11 cases

  • Bing LiEmail author
  • Wei-bing Chen
  • Shou-qing Wang
  • Ye-bo Wang
Original Article



Laparoscopic procedures involving a neonatal annular pancreas have only been sporadically reported in the literature. We herein present our initial experience with an annular pancreas in newborns treated via a laparoscopic approach.


A retrospective review of the laparoscopic methods used for an annular pancreas in 11 neonates from September 2009 to April 2013 was performed. Among the patients, seven were male and four were female. The age of the patients ranged from 1 to 13 days (mean 4.2 days). An annular pancreas was diagnosed under laparoscopic vision. In all of the cases, the surgical procedures were performed laparoscopically.


The operation was accomplished by a laparoscopic procedure in all cases. The length of the operation ranged from 70 to 145 min (mean, 96.6 min). Feedings started on postoperative days 4–7 (mean, day 5), and patients were discharged on postoperative days 9–15 (mean, day 10.6). Ten cases were followed up for 4–39 months (mean, 15.2 months). The case complicated with anal atresia died of pneumonia 6 months later after the procedure, but the other patients were doing well at the most recent follow-up examination.


The laparoscopic approach for an annular pancreas can be securely performed in the neonatal period. Our early experience suggests the outcomes were excellent.


Annular pancreas Diamond-shaped anastomosis Laparoscopy Neonate 


Conflict of interest

Bing Li and co-authors have no conflicts of interest.


  1. 1.
    Shan YS, Sy ED, Lin PW. Annular pancreas with obstructive jaundice: beware of underlying neoplasm. Pancreas. 2002;25:314–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Komuro H, Gotoh C, Urita Y, Fujishiro J, Shinkai T. A pediatric case of an unusual type of annular pancreas presenting with duodenopancreatic reflux. Pediatr Surg Int. 2012;28:715–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Zilberstein B, Sorbello MP, Orso IR, Cecconello I. Laparoscopic duodenal-Jejunal bypass for the treatment of duodenal obstruction caused by annular pancreas: description of a surgical technique. Surg Laparosc Endosc Percutan Tech. 2011;21:e60–4.PubMedCrossRefGoogle Scholar
  4. 4.
    Yigiter M, Yildiz A, Firinci B, Yalcin O, Akgun O, Ahmet BS. Annular pancreas in children: a decade of experience. Eur J Med. 2010;42:116–9.CrossRefGoogle Scholar
  5. 5.
    Kilbride H, Castor C, Andrews W. Congenital duodenal obstruction: timing of diagnosis during the newborn period. J Perinatol. 2010;30:197–200.PubMedCrossRefGoogle Scholar
  6. 6.
    Markljung E, Adamovic T, Ortqvist L, Wester T, Nordenskjöld A. A rare microduplication in a familial case of annular pancreas and duodenal stenosis. J Pediatr Surg. 2012;47:2039–43.PubMedCrossRefGoogle Scholar
  7. 7.
    Glüer S, Petersen C, Ure BM. Simultaneous correction of duodenal atresia due to annular pancreas and malrotation by laparoscopy. Eur J Pediatr Surg. 2002;12:423–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Riquelme M, Aranda A, Riquelme-Q M, Rodriquez C. Laparoscopic treatment of duodenal obstruction: report on first experiences in Latin America. Eur J Pediatr Surg. 2008;18:334–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Dankovcik R, Jirasek JE, Kucera E, Feyereisl J, Radonak J, Dudas M. Prenatal diagnosis of annular pancreas: reliability of the double bubble sign with periduodenal hyperechogenic band. Fetal Diagn Ther. 2008;24:483–90.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Milone L, Okhunov Z, Gumbs AA. Laparoscopic diagnosis of annular pancreas in a patient with mucinous cystoadenoma of the body of the pancreas. J Gastrointest Cancer. 2012;43:367–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Li B, Chen WB, Wang SQ, Liu SL, Li L. Laparoscopy-assisted surgery for neonatal intestinal atresia and stenosis: a report of 35 cases. Pediatr Surg Int. 2012;28:1225–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Bax NM, Ure BM, van der Zee DC, van Tuijl I. Laparoscopic duodenoduodenostomy for duodenal atresia. Surg Endosc. 2001;15:217.PubMedCrossRefGoogle Scholar
  13. 13.
    Jimenez JC, Emil S, Podnos Y, Nguyen N. Annular pancreas in children: a recent decade’s experience. J Pediatr Surg. 2004;39:1654–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Hulvat MC, Kumar RB, Newman BM, Muraskas JK. Annular pancreas in identical twin newborns. J Pediatr Surg. 2006;41:e19–21.PubMedCrossRefGoogle Scholar
  15. 15.
    McCollum MO, Jamieson DH, Webber EM. Annular pancreas and duodenal stenosis. J Pediatr Surg. 2002;37:1776–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  • Bing Li
    • 1
    Email author
  • Wei-bing Chen
    • 1
  • Shou-qing Wang
    • 1
  • Ye-bo Wang
    • 2
  1. 1.Department of Pediatric SurgeryHuai’an Women and Children’s HospitalJiang SuPeople’s Republic of China
  2. 2.Department of General Surgery, Huai’an First People’s HospitalNanjing Medical UniversityHuai’anPeople’s Republic of China

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