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Surgical tactics in inconsistency of duodenal stump

Surgical tactics in inconsistency of duodenal stump

Uzbekiston Tibbiet Zhurnali (6): 24-26

During 1996-2006 years 1131 patients have been operated for complicated ulcer of the stomach duodenum in the Surgery Department of the Tashkent Medical Academy. Of them 23 experienced inconsistency of duodenal stump, which accounted for 2% among all the operated patients and 12.7% among early postoperative complications. The patients were divided into 2 groups according to surgical tactics applied. The first group included 11, the second 12 patients. Causes leading to the development of the complication were ulcer on the posterior wall of the duodenum, big ulcer penetrated into the pancreas or hepatoduodenal ligament, use of infiltrated tissue for the formation of the stump and presence of a number of concurrent diseases. Use of "tampon-cigar" frequently resulted in accumulation of duodenal content in the subhepatic area with subsequent spreading into other sites of the abdominal cavity. Aspiration from duodenal leakage, presence of a drainage tube in the subhepatic area allowed restriction of the peritonitis, formation of narrow duodenal leakage and decrease of skin maceration around the tube. Use of early enteral feeding through a nasogastral tube prevented loss of proteins, electrolytes and enzymes and reduced a need for intravenous infusions.

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Accession: 013849507

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