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EPN 2021

Gamal Al Saied

Gamal Al Saied, Speaker at Pediatrics Conferences
Al Azhar University, Egypt
Title : Proximal transverse elliptical duodenoduodenostomy for the treatment of duodenal atresia : A novel technique


Background/purpose: Although duodenal atresia associated with or without annular pancreas is a common cause of congenital intestinal obstruction, the optimal technique of repair remains controversial. The objective of this study was to describe and evaluate the results that can be achieved by using a novel technique (Transverse Elliptical Duodenoduodenostomy).

Materials and methods: 15 neonates ( 9 boys and 6 girls) with duodenal atresia with or without annular pancreas had been operated upon by same author at Al-Azhar University Hospitals EgyptKing Abdul Aziz Specialist Hospital, and King Faisal Medical Complex, Saudi Arabia in the period from December 2002 to December 2020. The technique will be described in detail. All patients were followed up at OPD by the same author, range (2–48) months. Post surgical time to feedings, hospital length of stay, weight gain and Morbidity and mortality, upper gastrointestinal series (UGIS) and postoperative gastric emptying scans were the parameters of the study to evaluate the results.

Results: They were 15 neonates ( 9 boys and 6 girls),Their ages ranged from 2 to 7dayes.7 patients were premature (gestational age< 37 weeks) and two had Down’s syndrome. All patient had associated congenital anomalies including; annular pancreas in 8 cases, congenital heart disease in 12 cases, both esophageal atresia and vestibular anus in one case and renal abnormalities in 4 cases. At initial operation, duodenal atresia was noted in all patients (5 cases had a type I mucosal atresia, 6 had a fibrous cord connecting 2 atretic ends (type 2), and 4 had a complete separation (a gap) between the 2 atretic ends (type 3). Bile flow was observed in the proximal and distal duodenum after duodenotomy in one case. There was no additional sites of obstruction in all cases. The operative time ranged from 20–35 min. No mortalities were reported. On the 5th postoperative day UGIS showed no evidence of megaduodenum, leakage or obstruction. Gradual oral feeding started on the same day.

Conclusion: Transverse elliptical duodenoduodenostomy is safe and effective. It avoids the postoperative stenosis and obstruction on long term follow up.

Keywords: Duodenal atresia, Elliptical duodenoduodenostomy.


Professor Gamal Al Saied had been graduated in December 1986 from Al-Azhar University with Bachelor Degree in medicine and surgery with general grade very good with honor. His rank was the 9th in top 10  graduate  list of Faculty of Medicine Al-Azhar University Cairo, Egypt. He had got the Master Degree (MSc) in pediatric surgery, in November 1991. Then, he was appointed as a demonstrator of pediatric surgery in 1992, then, assistant lecturer of pediatric surgery in 1993 in the Pediatric Surgery Department. He had got a Medical Doctorate degree (MD) in November1998. Then, he was promoted to a lecturer of pediatric surgery in the Pediatric Surgery Department. In May-2004, he was promoted to an assistant professor of pediatric surgery in Pediatric Surgical department, AlAzhar University Hospitals.

In 2008, he had got a Fellowship of European Board in Pediatric Surgery, Glasgow, Scotland. In June 2009 he was promoted to be a full professor of pediatric surgery in Pediatric Surgical department, Al-Azhar University Hospitals. He had 2 published theses (MSc and MD) and he supervised 2 thesis of Master Degree. Also, he has published 35 international researches in international journals of pediatric surgery and chapter in international text book (CURRENT CONCEPTS OF URETHROPLASTY) Edited by Donkov I. 2011, pp 35-42. He has invited as an international speaker and chairperson in many international conferences of pediatric surgery.

Currently, He is an Editor in Chief for 2 international pediatric surgery journals and editor for 13 international pediatric surgery journals. He is also reviewers for many international pediatric surgery journals. In 2003, he was the founder and head of pediatric surgery unit at King Abdul Aziz Specialist Hospital Taif, Saudi Arabia. He has a great and long term experience in neonatal and pediatric surgery field (open and laparoscopic). Recently, in era of COVID 19, he has invited as an international speaker in many international pediatric surgery webinars. Research interest: Neonatal and pediatric laparoscopic surgery and Hypospadiology.