title: Reliable procedure for closing the duodenal stump for bleeding posterior duodenal ulcer.
abstract: Bleeding posterior duodenal ulcers is a critical problem especially in patients of advanced age. Surgical treatment should obtain efficient and stable hemostasis and avoid digestive fistulas due to leakage of the duodenal stump. The main difficulty lies in the closure of the duodenal stump. A procedure using intramural dissection of the duodenum and closure by means of a stapler is reported for a series of 40 patients without recurrent bleeding or duodenal fistula. Seven patients (17%) died from associated diseases, especially respiratory insufficiency (3 patients) and cirrhotic liver failure (2 patients).
authors.affiliation: Department of General and Digestive Surgery, Hôpitaux Universitaires de Strasbourg-Hautepierre, France.
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.forename: S
authors.initials: S
authors.lastname: Rohr
authors.forename: N
authors.initials: N
authors.lastname: de Manzini
authors.forename: B
authors.initials: B
authors.lastname: Dai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D013528:Surgical Staplers; D015996:Survival Rate; D013536:Suture Techniques / Q000295:instrumentation*