Novel jejunoduodenostomy technique for prevention of duodenal stump blowout following gastrectomy.
BACKGROUND
Many patients undergo gastrectomy every year with a risk of duodenal stump blowout. We compared the conventional surgical techniques with a new and simple method of reconstruction to prevent this complication.


METHODS
We reviewed the medical records of all the patients who underwent gastrectomy from 2002 to 2013 (total or partial distal gastrectomies with Billroth II, Roux-en-Y, and our new technique of reconstruction) in Shohada Tajrish University hospital, Tehran, Iran.


RESULTS
A total of 179 patients were eligible for the study: 101 had undergone the new technique (study group) and 78 had undergone the conventional methods (control group). There were three cases of duodenal stump blowout, all in the control group (4 %, P<0.05). One was fatal (1 %). The post-operative hospital stay was significantly shorter in the study group (8.93 vs. 11.51 days, P<0.05).


CONCLUSIONS
Our results show that this new technique can effectively prevent duodenal stump blowout. Other advantages of this technique include the maintenance of physiological passage of food and a safe route for future diagnostic and therapeutic endoscopic interventions.


CONCLUSIONS
We present a simple technique that eliminates the risk of duodenal stump blowout. Randomized controlled trials are necessary to confirm our findings.
Department of General and Vascular Surgery, Shohada Tajrish General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, makmotamedi@gmail.com.
Mohammad Ali Kalantar
MA
Motamedi
Jalaledin
J
Khoshnevis
Mohammad Reza Kalantar
MR
Motamedi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control*; D004385:Duodenostomy / Q000379:methods*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery; D016896:Treatment Outcome