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

Ali BI, Park CH, Song KY - J Gastric Cancer (2016)

Bottom Line: The patients' clinical outcomes were analyzed.All 3 management modalities were successful; none of the patients needed further operative intervention.This management modality can help obviate the need for surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Fluoroscopy-guided pigtail catheter insertion.
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Figure 2: Fluoroscopy-guided pigtail catheter insertion.

Mentions: Percutaneous drainage or duodenostomy was performed as outlined in our previous report.3 Briefly, patients were scheduled for drainage catheter insertion immediately after confirmation of duodenal stump leakage (Fig. 1). Following tubography, the fluid cavity was percutaneously punctured using an 18-gauge Chiba needle (TSK Laboratory, Tochigi, Japan) under ultrasound- or cone-beam CT guidance. A pigtail catheter (Sungwon Medical, Gwangju, Korea) was inserted over a guidewire under fluoroscopic guidance (Fig. 2). Follow-up tubography was performed 1 to 3 weeks later, once the patient's acute symptoms had subsided and the discharge through the drainage catheter had either decreased or stopped.


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

Ali BI, Park CH, Song KY - J Gastric Cancer (2016)

Fluoroscopy-guided pigtail catheter insertion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834618&req=5

Figure 2: Fluoroscopy-guided pigtail catheter insertion.
Mentions: Percutaneous drainage or duodenostomy was performed as outlined in our previous report.3 Briefly, patients were scheduled for drainage catheter insertion immediately after confirmation of duodenal stump leakage (Fig. 1). Following tubography, the fluid cavity was percutaneously punctured using an 18-gauge Chiba needle (TSK Laboratory, Tochigi, Japan) under ultrasound- or cone-beam CT guidance. A pigtail catheter (Sungwon Medical, Gwangju, Korea) was inserted over a guidewire under fluoroscopic guidance (Fig. 2). Follow-up tubography was performed 1 to 3 weeks later, once the patient's acute symptoms had subsided and the discharge through the drainage catheter had either decreased or stopped.

Bottom Line: The patients' clinical outcomes were analyzed.All 3 management modalities were successful; none of the patients needed further operative intervention.This management modality can help obviate the need for surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus