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Management of the Duodenal Stump

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Abstract

One of the most serious complications after gastrectomy is leakage from the duodenal stump. Historically duodenal leak has been a potentially devastating complication after Billroth II resections following emergency surgery for duodenal ulcer perforation.

Causes of duodenal stump suture dehiscence are:

  • Technical failure

  • Postoperative pancreatitis

  • Attempt to close a severely diseased and scarred, edematous duodenal stump

  • Blood clots in the duodenal bed leading to super infection

  • Excessive use of sutures at the stump leading to necrosis

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Authors and Affiliations

  1. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Jakob Izbicki FACS, FRCS Ed. Hon.

  2. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Yogesh Vashist

  3. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Florian Gebauer

Authors
  1. Yogesh Vashist
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  2. Florian Gebauer
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  3. Jakob Izbicki FACS, FRCS Ed. Hon.
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Corresponding author

Correspondence to Yogesh Vashist .

Editor information

Editors and Affiliations

  1. Department of Surgery, Swiss HPB and Tra, University Hospital Zurich, Zürich, Switzerland

    PIERRE-ALAIN CLAVIEN

  2. Division of Subspecialty General Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

    Michael G. Sarr

  3. Department of Surgery and Radiology Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Yuman Fong

  4. Department of General Surgery, Chiba University, Chiba, Japan

    Masaru Miyazaki

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© 2016 Springer-Verlag Berlin Heidelberg

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Vashist, Y., Gebauer, F., Izbicki, J. (2016). Management of the Duodenal Stump. In: CLAVIEN, PA., Sarr, M., Fong, Y., Miyazaki, M. (eds) Atlas of Upper Gastrointestinal and Hepato-Pancreato-Biliary Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46546-2_34

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  • DOI: https://doi.org/10.1007/978-3-662-46546-2_34

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46545-5

  • Online ISBN: 978-3-662-46546-2

  • eBook Packages: MedicineMedicine (R0)

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