Incidence and Prognosis of Duodenal Stump Leakage in Laparoscopic Gastrectomy for Gastric Cancer According to Treating Duodenal Stump

Min Chan Kim*

Department of Surgery, Dong-A University College of Medicine, Korea

^*Correspondance to: Min Chan Kim 

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Abstract:

Background: Duodenal Stump Leakage (DSL) can be a feared and life-threatening complication
after gastrectomy. DSL after laparoscopic surgery can be a bigger disappointment than that after
open surgery.
Aim: To compare surgical outcomes according to three surgical techniques to treat duodenal stump
in laparoscopic gastrectomy and establish the best surgical technique to prevent duodenal stump
leakage in laparoscopic gastrectomy for gastric cancer.
Materials and Methods: A total of 762 patients who underwent laparoscopic gastrectomy for gastric
cancer between April 2003 and March 2017 were enrolled. They were divided into three groups based
on surgical technique used to treat duodenal stump: Only glue group (group G), Polyglycolic Acid
(PGA) sheet and glue group (group P+G), and laparoscopic reinforcement suture with Polyglycolic
Acid (PGA) sheet and glue group (group R+P+G). Clinicopathologic characteristics and surgical
outcomes were compared among three groups retrospectively.
Results: Overall incidence of DSL after laparoscopic gastrectomy for gastric cancer was 1.0%
(8/762). Among them, four patients with major DSL unfortunately died after reoperation. There are
no significant differences in surgical outcomes among the three groups, except operation time. The
operation time was the shortest in the R+P+G group. Incidences of DSL in G group and P+G group
were 2.1% and 1.1 %, respectively. However, there was no DSL in the R+P+G group.
Conclusion: Application of Polyglycolic Acid (PGA) sheet and fibrin glue on laparoscopic
reinforcement suture site for stapler line of duodenal stump can be one of prevention methods for
DSL after laparoscopic gastrectomy for gastric cancer.

Keywords:

Laparoscopy; Gastrectomy; Postoperative complication; Duodenum

Cite the Article:

Kim MC. Incidence and Prognosis of Duodenal Stump Leakage in Laparoscopic Gastrectomy for Gastric Cancer According to Treating Duodenal Stump. World J Surg Surgical Res. 2020; 3: 1211..