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  • Title: [Prevention and complex treatment of duodenal stump incompetence].
    Author: Salikhov IA, Fedorov VV, Krasil'nikov DM, Knubovets SIa, Minnegaliev MM, Mosikhin BB.
    Journal: Khirurgiia (Mosk); 1989 Oct; (10):23-6. PubMed ID: 2593566.
    Abstract:
    The results of surgical treatment of 1,069 patients for gastric and duodenal ulcer were studied. Duodenal stump incompetence (DSI) developed in 25 patients (6.3%) after the Billroth II operation; the incompetence was manifested by three clinical forms: infiltrative, primary-fistular, and perforative-peritoneal. Each form of DSI calls for specific tactics of treatment. The perforative-peritoneal form is most dangerous; during its operative management active aspiration-perfusion drainage of the zone of the stump must be installed and the duodenum relieved of a load as much as possible. Drugs reducing pancreatic function, postural drainage, and a diet is included in the complex of therapeutic measures in DSI. The wide introduction of organ-preserving operations into surgical practice will make it possible to avoid this threatening complication.
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