title: Risk factors for duodenal stump leakage after gastrectomy for gastric cancer and management technique of stump leakage.
abstract: OBJECTIVE
  The goal of this study was to elucidate the risk factors for duodenal stump leakage after gastrectomy for gastric cancer. In addition, the management of duodenal stump leakage is reviewed.
  
  
  METHODS
  From January 2002 through December 2012, 1,195 patients with gastric cancer who underwent gastric R0 resection were enrolled in this study. The clinicopathologic features, postoperative outcomes (i.e., operation time, hospital stay, surgical procedures, method of duodenal stump closure, retrieved lymph nodes), and the risk factors of duodenal stump leakage were analyzed.
  
  
  RESULTS
  Of the 1,195 patients, 13 patients (1.1%) suffered duodenal stump leakage. Most of the patients with duodenal stump leakage were male (92.3%). Nine patients underwent a subtotal gastrectomy with Billroth- II or Roux-en-Y anastomosis; the other four patients underwent a total gastrectomy with a Roux-en-Y anastomosis. There were two mortalities. With univariate and multivariate analysis, age was the most predictable factor for duodenal stump leakage (p= 0.034, p=0.044) CONCLUSIONS: Duodenal stump leakage was affected by the age. For older patients who undergo a radical gastrectomy for gastric cancer, the surgeon must pay meticulous attention to the transection and mobilization of the duodenum in order to prevent duodenal stump leakage.
authors.forename: Ki-Han
authors.initials: KH
authors.lastname: Kim
authors.forename: Min-Chan
authors.initials: MC
authors.lastname: Kim
authors.forename: Ghap-Joong
authors.initials: GJ
authors.lastname: Jung
mesh_terms: D000367:Age Factors; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects* / Q000401:mortality; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000401:mortality; D005763:Gastroenterostomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome