Outcomes of Non-Operative Treatment for Duodenal Stump Leakage after Gastrectomy in Patients with Gastric Cancer

• Published in: Journal of gastric cancer Vol. 16; no. 1; pp. 28 - 33
• Main Authors: Ali, Bandar Idrees, Park, Cho Hyun, Song, Kyo Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Gastric Cancer Association 01.03.2016; 대한위암학회
• Subjects: Original; 일반외과학; Tube duodenostomy; Non-operative treatment; Duodenal stump leakage; Gastrectomy; Stomach neoplasms
• ISSN: 2093-582X; 2093-5641
• DOI: 10.5230/jgc.2016.16.1.28

We evaluated the clinical outcomes of the non-operative management of post-gastrectomy duodenal stump leakage in patients with gastric cancer. 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. 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. 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.