Management of duodenal injury: our experience and the value of tube duodenostomy.
BACKGROUND
The aim of this study was to report our experience with duodenal injuries and determine if primary repair and/or tube duodenostomy are valid options for definitive operative repair of severe duodenal injuries.


METHODS
Sixty-seven patients who underwent surgery for duodenal injuries were evaluated. Management of duodenal injury was classified as primary repair and tube decompression.


RESULTS
Fifty-nine patients were injured by a penetrating mechanism, and eight were injured by blunt mechanism. The most common injury site was in the second portion of the duodenum. There were no significant differences between the two groups with respect to morbidity and mortality rate. In 35 patients without morbidity, the mean length of hospital stay was 18.53+/-1.85 days in the tube duodenostomy group and 11.45+/-1.92 days in the primary repair group, and the difference was statistically significant. In the 32 patients with morbidity, the mean length of hospital stay was 47.05+/-10.46 days in the tube duodenostomy group and 49.86+/-10.86 days in primary repair group, but there was no statistically significant difference between the groups.


CONCLUSIONS
Primary repair is suitable in the vast majority of duodenal injuries; tube duodenostomy increases the length of hospital stay and does not improve clinical outcome.
Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakir, Turkey. sadullahgirgin@gmail.com
Sadullah
S
Girgin
Ercan
E
Gedik
Yusuf
Y
Yağmur
Ersin
E
Uysal
Bilsel
B
Baç
D000007:Abdominal Injuries / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D004385:Duodenostomy; D004386:Duodenum / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000601:surgery; D006801:Humans; D022125:Lacerations / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000601:surgery; D014950:Wounds, Penetrating / Q000601:surgery; D055815:Young Adult