Duodenal Stump Açılma Sebepleri ve Tedavisi Hakkında Bir Araştırma
Abstract
Duodenal stump leakage is a serious postoperative complication following Billroth II gastrectomy. Between 1955 and 1969, 1,157 patients underwent Billroth II resections at Ankara University’s First Surgical Clinic, and 15 (1.3%) developed duodenal stump leaks. We reviewed these cases alongside published series to identify etiologic factors—local (vascular compromise, traumatic handling, closure of inflamed tissue, pressure from drains, parasitic damage), systemic (anemia, hypoproteinemia, dehydration), and obstructive (jejunal limb kinking, Petersen’s hernia). Leaks typically presented on postoperative days 3–7 with sudden epigastric pain, localized peritonitis signs, fever, and tachycardia. Overall mortality was 48.6%, lower than previously reported rates (~85%). Management ranged from conservative care with jejunostomy to reoperation and stump closure. Early recognition, adequate drainage, nutritional support, and judicious surgical technique are essential to reduce morbidity and mortality.
Keywords
duodenal stump leak, Billroth II gastrectomy, postoperative peritonitis, stump closure, jejunostomy
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