Risk factors for duodenal stump leakage after gastrectomy for gastric cancer and management technique of stump leakage.

Background/Aims: The goal of this stuay was to elucidate the risk factors for duodenal stump leakage after gastrectomy for gastric cancer. In addition, the management of duodenal stump leakage is reviewed. Methodology: From January 2002 through December 2012, 1,195 patients with gastric cancer who underwent gastric RO resection were enrolled in this study. The clinicopathoogic features, postoperative outcomes (i.e., operation time, hospital stay, surgical procedures, method of duodenal stump closure, retrieved lymph nodes), and the risk factors of duodenal stump leakage were analyzed. Results: Of the 1,195 patients, 13 patients (1.1%) suffered duodenal-stump leakage. Most of the patients with duodenal stump leakage were male (92.3%). Nine patients underwent a subtotal gastrectomy with Bill:rot II or Roux-en-Y anastomosis; the other four patient underwent a total gastrectorny with a Roux-en-Y tomosis. There were two mortalities. With univariat and multivariate analysis, age was the most predictabl factor for duodenal stump leakage (p=0.034, p=0.044) Conclusions: Duodenal stump leakage was affected b3/ the age. For older patients who undergo a radical gastrectomy for gastric cancer, the surgeon must pay me' ticulous attention to the transection and mobilizatio of the duodenum in order to prevent duodenal stump leakage.