The use of catheter duodenostomy in gastric resection for duodenal ulcer

Abstract

Duodenal stump leakage occurs in 2 to 3 per cent of gastric resections for duodenal ulcer and is responsible for approximately 50 per cent of the mortality rate. Catheter duodenostomy has been used by an increasing number of surgeons as one method of avoiding a difficult duodenal dissection and closure. During a ten year period, catheter duodenostomy was used thirty-three times by two of us. It was employed in sixteen patients at the Los Angeles County Harbor General Hospital. In the thirty-three private patients, one death occurred from myocardial infarction; three major complications were encountered. There were seven deaths in the Harbor General Hospital; and, in our opinion, this is an indication of the more debilitated condition in this group of patients. All seven were operated upon for massive gastrointestinal hemorrhage. Catherer duodenostomy is a simple method of managing the “difficult” duodenal stump.