Postoperative peritonitis originating from the duodenum: operative management by intubation and continuous intraluminal irrigation.
BACKGROUND
The mortality rate associated with postoperative peritonitis remains high, especially when the source of infection cannot be eradicated. Such is the case with peritonitis arising from the duodenum, as primary closure is futile and intubation alone may be followed by local complications.


METHODS
Forty-nine consecutive patients with postoperative peritonitis originating from a duodenal leak and a mean Acute Physiology And Chronic Health Evaluation II score of 17.7 were treated according to the following procedure: a three-channelled spiral drain was inserted through the leak and extraluminal drains were placed near the duodenal defect. Intraluminal irrigation was undertaken immediately through the infusion channel of the spiral drain.


RESULTS
Eleven patients died and 26 suffered complications. The mean duration of intubation was 21 days.


CONCLUSIONS
Intubation with intraluminal irrigation has proved effective in a homogeneous group of patients with peritonitis due to duodenal leakage.
Parc
Y
Y
Department of Digestive Surgery, Hôpital Saint-Antoine, University Pierre et Marie Curie, Paris, France.
Frileux
P
P
Vaillant
J C
JC
Ollivier
J M
JM
Parc
R
R
D000328:Adult; D000368:Aged; D004378:Duodenal Diseases / Q000150:complications* / Q000601:surgery; D005260:Female; D005751:Gastric Lavage / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000628:therapy*; D011183:Postoperative Complications / Q000628:therapy*; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome