Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and CholangiostomyReport as inadecuate




Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy - Download this document for free, or read online. Document in PDF available to download.

Case Reports in SurgeryVolume 2013 2013, Article ID 430295, 5 pages

Case ReportDepartment of General Surgery, General Hospital of Drama, End of Hippokratous Street, 66100 Drama, Greece

Received 5 July 2013; Accepted 23 August 2013

Academic Editors: T. Hotta and S.-I. Kosugi

Copyright © 2013 Konstantinos Blouhos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 + number 13 lymph nodes adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula.





Author: Konstantinos Blouhos, Konstantinos A. Boulas, Anna Konstantinidou, Ilias I. Salpigktidis, Stavroula P. Katsaouni, Konstantino

Source: https://www.hindawi.com/



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