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KMID : 0914820160160010028
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Journal of the Korean Gastric Cancer Association
2016 Volume.16 No. 1 p.28 ~ p.33
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Outcomes of Non-Operative Treatment for Duodenal Stump Leakage after Gastrectomy in Patients with Gastric Cancer
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Bandar Idrees Ali
Park Cho-Hyun
Song Kyo-Young
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Abstract
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Purpose: We evaluated the clinical outcomes of the non-operative management of post-gastrectomy duodenal stump leakage in patients with gastric cancer.
Materials and Methods: A total of 1,230 patients underwent gastrectomy at our institution between 2010 and 2014. Duodenal stump leakage was diagnosed in 19 patients (1.5%), and these patients were included in this study. The management options varied with patient condition; patients were managed conservatively, with a pigtail catheter drain, or by tube duodenostomy via a Foley catheter. The patients’ clinical outcomes were analyzed.
Results: Duodenal stump leakage was diagnosed in all 19 patients within a median of 10 days (range, 1~20 days). The conservative group comprised of 5 patients (26.3%), the pigtail catheter group of 11 patients (57.9%), and the Foley catheter group of 3 patients(15.8%). All 3 management modalities were successful; none of the patients needed further operative intervention. The median hospital stay was 18, 33, and 42 days, respectively.
Conclusions: Non-operative management of duodenal stump leakage for selected groups of patients with gastric cancer was effective for control of intra-abdominal sepsis. This management modality can help obviate the need for surgical intervention.
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KEYWORD
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Duodenal stump leakage, Non-operative treatment, Tube duodenostomy, Gastrectomy, Stomach neoplasms
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