Surgical management of duodenal stump fistula after elective gastrectomy for malignancy: an Italian retrospective multicenter study

Luca Cozzaglio, Marco Giovenzana, Roberto Biffi, Lorenzo Cobianchi, Arianna Coniglio, Massimo Framarini, Leonardo Gerard, L. Gianotti, Alberto Marchet, Vincenzo Mazzaferro, Paolo Morgagni, Elena Orsenigo, S. Rausei, Fabrizio Romano, Fausto Rosa, Riccardo Rosati, Franco Roviello, Matteo Sacchi, Emanuela Morenghi, Vittorio Quagliuolo

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Abstract

Background: Duodenal stump fistula (DSF) is a severe complication of gastrectomy. Although nonsurgical therapy is preferred, surgery is still mandatory in one third of DSF patients. The aim of this article is to analyze the surgical management of DSF and factors related to its outcome. Methods: We performed a retrospective multicenter study using data from January 1990 to November 2011 in 16 Italian surgery centers. We collected 8,268 elective gastrectomies for malignancies, 7,987 by the laparotomic and 281 by the laparoscopic approach. Two hundred five patients developed a DSF, 75 of whom underwent surgery for DSF. We analyzed mortality and DSF healing time as well as the impact of clinical, oncological, and surgical characteristics. Results: The laparoscopic approach increased the risk of DSF development (odds ratio 5.6, 95 % confidence interval 2.7–10.6, P

Original languageEnglish
Pages (from-to)273-279
Number of pages7
JournalGastric Cancer
Volume19
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Keywords

  • Complications
  • Duodenal stump fistula
  • Gastrectomy
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

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