Triple-tube drainage versus jejunal serosal patch for management of releaked perforated duodenal ulcer after initial omental patch repair

Abstract

Background Perforated duodenal ulcer (DU) is a dangerous and life-threatening condition, with associated high mortality, especially when there is releakage after initial repair with omental patch. There are multiple methods recommended by different studies for its management. These methods include cholecystoduodenoplasty, a jejunal serosal patch, triple-tube drainage, T-tube duodenostomy, and conservative methods. The aim of the study is to compare between triple-tube drainage and jejunal serosal patch as methods of management of releaked DU regarding the efficacy, failure, and mortality. Patients and methods This study included 20 patients presented with releaked perforated DU treated initially with pedicled omental patch technique. They were divided randomly into two groups: group A included 10 patients who were treated by triple-tube drainage and group B included 10 patients who were treated by jejuna serosal patch. Results The mean age of group A patients was 54 years, whereas for group B patients, it was 51 years. Most of the group A patients were males (80%) and also 90% of the group B patients were males. All patients (100%) of both groups were presented with manifestations of shock like hypotension and palpitation. The average length of hospital stay was 11 days (range, 8–15 days) for the group A patients and 13 days (range, 7–19 days) for group B patients. Conclusion Releaked perforated DU after initial omental patch repair is a life-threatening entity and needs urgent resuscitation and interference. There are several methods of its management, among them are triple-tube drainage and jejunal serosal patch. Both methods have nearly the same success, complications, and mortality rates.