Brief Articles
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World J Gastroenterol. Apr 28, 2009; 15(16): 1990-1998
Published online Apr 28, 2009. doi: 10.3748/wjg.15.1990
Computer simulation of flow and mixing at the duodenal stump after gastric resection
Nenad Filipovic, Aleksandar Cvetkovic, Velibor Isailovic, Zoran Matovic, Mirko Rosic, Milos Kojic
Nenad Filipovic, Aleksandar Cvetkovic, Velibor Isailovic, Zoran Matovic, Mirko Rosic, Faculty of Mechanical Engi-neering, University of Kragujevac, Kragujevac 34000, Serbia
Nenad Filipovic, Velibor Isailovic, Milos Kojic, Research and Development Center for Bioengineering, Kragujevac 34000, Serbia
Nenad Filipovic, Milos Kojic, Harvard School of Public Health, Boston, MA 02115, United States
Aleksandar Cvetkovic, Zoran Matovic, Clinical Center Kragujevac, Kragujevac 34000, Serbia
Mirko Rosic, Medical Faculty Kragujevac, Kragujevac 34000, Serbia
Milos Kojic, The University of Texas Health Science Center, Houston TX77030, United States
Author contributions: Filipovic N, Kojic M and Rosic M designed research; Cvetkovic A, Matovic Z and Rosic M designed and performed experimental research; Filipovic N and Isailovic V created and ran computer simulations; Filipovic N, Kojic M and Cvetkovic A wrote the paper.
Correspondence to: Nenad Filipovic, Faculty of Mechanical Engineering, University of Kragujevac, S Janjica 6, Kragujevac 34000, Serbia.
Telephone: +381-34-334379    
Fax: +381-34-333192
Received: December 23, 2008
Revised: March 5, 2009
Accepted: March 12, 2009
Published online: April 28, 2009

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.

Keywords: Computer simulation, Gastric resection, Duodenal stump, Billroth II, Pressure distribution