Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy

Blouhos, Konstantinos; Boulas, Konstantinos A.; Konstantinidou, Anna; Salpigktidis, Ilias I.; Katsaouni, Stavroula P.; Ioannidis, Konstantinos; Hatzigeorgiadis, Anestis

doi:10.1155/2013/430295

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Surgical treatment was reported by 13 studies and applied in just over half whole population analyzed (53%, 157/294) [2–7, 11, 13, 15, 19–22]. Peritoneal lavage and abdominal drainage were performed in all reoperations, often in association to other surgical procedures.…”

Section: Resultsmentioning

confidence: 99%

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Management of duodenal stump fistula after gastrectomy for malignant disease: a systematic review of the literature

Zizzo

Ugoletti²,

Manzini³

et al. 2019

BMC Surg

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Background Duodenal stump fistula (DSF) remains one of the most serious complications following subtotal or total gastrectomy, as it endangers patient’s life. DSF is related to high mortality (16–20%) and morbidity (75%) rates. DSF-related morbidity always leads to longer hospitalization times due to medical and surgical complications such as wound infections, intra-abdominal abscesses, intra-abdominal bleeding, acute pancreatitis, acute cholecystitis, severe malnutrition, fluids and electrolytes disorders, diffuse peritonitis, and pneumonia. Our systematic review aimed at improving our understanding of such surgical complication, focusing on nonsurgical and surgical DSF management in patients undergoing gastric resection for gastric cancer. Methods We performed a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. PubMed/MEDLINE, EMBASE, Scopus, Cochrane Library and Web of Science databases were used to search all related literature. Results The 20 included articles covered an approximately 40 years-study period (1979–2017), with a total 294 patient population. DSF diagnosis occurred between the fifth and tenth postoperative day. Main DSF-related complications were sepsis, abdominal abscess, wound infection, pneumonia, and intra-abdominal bleeding. DSF treatment was divided into four categories: conservative (101 cases), endoscopic (4 cases), percutaneous (82 cases), and surgical (157 cases). Length of hospitalization was 21–39 days, ranging from 1 to 1035 days. Healing time was 19–63 days, ranging from 1 to 1035 days. DSF-related mortality rate recorded 18.7%. Conclusions DSF is a rare but potentially lethal complication after gastrectomy for gastric cancer. Early DSF diagnosis is crucial in reducing DSF-related morbidity and mortality. Conservative and/or endoscopic/percutaneous treatments is/are the first choice. However, if the patient clinical condition worsens, surgery becomes mandatory and duodenostomy appears to be the most effective surgical procedure.

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Section: Resultsmentioning

confidence: 99%

“…In almost all cases, surgical treatment was performed in the presence of sepsis and / or haemodynamic instability. Available data showed a 71.5% success rate [2–7, 11, 13, 15, 19–22].…”

Section: Resultsmentioning

confidence: 99%

Management of duodenal stump fistula after gastrectomy for malignant disease: a systematic review of the literature

Zizzo

Ugoletti²,

Manzini³

et al. 2019

BMC Surg

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“…There have been case reports describing blowout occurring as early as postoperative day 1, but this is extremely rare and should raise suspicion of a technical failure during duodenal closure, such as stapler malfunction [8]. Early diagnosis of a duodenal stump blowout is essential to reducing the associated morbidity and mortality, as these patients often require emergent reoperation.…”

Section: Clinical Presentation Of Blowoutmentioning

confidence: 99%

Duodenal Stump Blowout

Speicher

Barbas

et al. 2015

Gastrointestinal Surgery

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“…После резекции желудка несостоя-тельность культи ДПК развивается в 1-3% наблюдений [5,9,21]. В крупном мультицентровом исследовании, в котором проанализированы 3785 тотальных и субтоталь-ных резекций желудка, выявлена большая частота разви-тия НДС в группе субтотальной резекции с реконструкци-ей по Ру по сравнению с вариантом реконструкции по Бильрот-II (3,4% против 1,1%; р<0,001) [9].…”

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