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Volkov V., Volkov S.
Clinical assessment of certain methods for duodenal stump closure in supra-pyloric gastrectomy and total gastrectomy
Keywords: duodenal stump closure, gastrectomy, modified Plenk technique, supra-pyloric gasterctomy, duodenal stump leakage
A retrospective analysis of duodenal stump closure results in 846 patients who underwent gastectomy due to gastric cancer and other pathologies of this organ, and those in 43 patients after closure of supra-pyloric stump in gasterctomy was carried out. Out of 785 patients (92,79%) in whom stump closure was performed by standard hand suturing or by a tantalum suture using a suturing device UO-40, leakage of stump sutures was noted in 2 patients (0,25%). In 43 patients who underwent gastric resection for low-sited complicated («difficult») duodenal ulcer with supre-pyloric stump formation using a modified method originally described by A.Plenk, leakage in stump sutures was found in 1 patient (2,3%). Duodenal stump closure in gastrectomy using either standard hand suturing or a machine stitch technique gives similar results – 0,40% versus 0,19% respectively (p > 0,05), ensuring closure safety in 99,8% cases. A modified A.Plenk technique allows to provide safety in supre-pyloric stump closure in 97,7%. The study established that closure safety of duodenal stump and in particular that of supra-pyloric stump largely depends on proper choice of surgical method and its technical implementation in every particular case.
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About authors
- Volkov Vladimir
- Doctor of Medical Sciences, Professor, Head of Surgical Diseases Department, Chuvash State University, Russia, Cheboksary (volkovserguei@mail.ru; )
- Volkov Sergey
- Doctor of Medical Sciences, Professor of Surgical Diseases Department, Chuvash State University, Russia, Cheboksary (volkovserguei@mail.ru; )
Article link
Volkov V., Volkov S. Clinical assessment of certain methods for duodenal stump closure in supra-pyloric gastrectomy and total gastrectomy [Electronic resource] // Acta medica Eurasica. – 2018. – №1. P. 1-8. – URL: https://acta-medica-eurasica.ru/en/single/2018/1/1/.