Hepato-gastroenterology · 1996
Surgical results of corrosive injuries involving esophagus to jejunum.
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Wu M H, Lai W W, Hwang T L, Lee S C, Hsu H K, Lin T S
Аннотация
BACKGROUND/AIM: Severe corrosive injury involving esophagus to jejunum remains an unique surgical problem which is associated with high mortality and morbidity.
MATERIAL AND METHODS: Herein we report the outcomes of 28 caustic patients who underwent resections of the stomach, duodenum, a segment of jejunum, and adjacent involving organs.
RESULTS: In all of these patients except one, esophagectomy was also performed. The concomitant procedures included pancreaticojejunostomy (n = 24), choledochojejunosotmy (n = 4), cholecystostomy (n = 4), common bile duct or pancreatic duct drainage, feeding and drainage jejunostomies, and cervical esophagostomy. Major complications consisted of bile leakage (n = 10), bile-bronchial fistula (n = 2), internal bleeding due to vessel necrosis (n = 5), peritonitis (n = 4), acute renal failure (n = 4), and septicemia (n = 4). There were 13 hospital deaths (46.4%) and three late deaths. Eight out of 12 survivors underwent subsequent reconstruction of esophagus. The remaining four survivors depended on jejunostomy feeding.
CONCLUSIONS: Early approaches and appropriate procedures can save a number of patients with corrosive injury involving esophagus to jejunum.
MATERIAL AND METHODS: Herein we report the outcomes of 28 caustic patients who underwent resections of the stomach, duodenum, a segment of jejunum, and adjacent involving organs.
RESULTS: In all of these patients except one, esophagectomy was also performed. The concomitant procedures included pancreaticojejunostomy (n = 24), choledochojejunosotmy (n = 4), cholecystostomy (n = 4), common bile duct or pancreatic duct drainage, feeding and drainage jejunostomies, and cervical esophagostomy. Major complications consisted of bile leakage (n = 10), bile-bronchial fistula (n = 2), internal bleeding due to vessel necrosis (n = 5), peritonitis (n = 4), acute renal failure (n = 4), and septicemia (n = 4). There were 13 hospital deaths (46.4%) and three late deaths. Eight out of 12 survivors underwent subsequent reconstruction of esophagus. The remaining four survivors depended on jejunostomy feeding.
CONCLUSIONS: Early approaches and appropriate procedures can save a number of patients with corrosive injury involving esophagus to jejunum.