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Atlas of Upper Gastrointestinal and Hepato-Pancreato-Biliary Surgery pp 281–284Cite as

Management of the Duodenal Stump

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Abstract

One of the most serious complications in the postoperative period after gastrectomy is a leakage from the duodenal stump. Historically it has occurred most frequently in Billroth II resections following emergency surgery for duodenal ulcer perforating in the pancreatic head and less frequently after resections for gastric cancer. 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 infection

  • Excessive use of sutures at the stump leading to necrosis

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Author notes

  1. Matthias Peiper & Wolfram T. Knoefel

    Present address: Department of Surgery, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany

Authors and Affiliations

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

    Matthias Peiper & Wolfram T. Knoefel

Authors
  1. Matthias Peiper
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  2. Wolfram T. Knoefel
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Editor information

Editors and Affiliations

  1. Department of Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Pierre-Alain Clavien MD, PhD  & Panco Georgiev MD  & 

  2. Department of Surgery, Division of Gastroenterologic and General Surgery, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Michael G. Sarr MD

  3. Department of Surgery, Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Yuman Fong MD

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© 2007 Springer-Verlag Berlin Heidelberg

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Peiper, M., Knoefel, W.T. (2007). Management of the Duodenal Stump. In: Clavien, PA., Sarr, M.G., Fong, Y., Georgiev, P. (eds) Atlas of Upper Gastrointestinal and Hepato-Pancreato-Biliary Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68866-2_32

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  • DOI: https://doi.org/10.1007/978-3-540-68866-2_32

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-20004-8

  • Online ISBN: 978-3-540-68866-2

  • eBook Packages: MedicineMedicine (R0)

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