Universität zu Köln

Chevallay, Mickael, Lorenz, Florian, Bichard, Philippe, Frossard, Jean-Louis, Schmidt, Thomas, Goeser, Tobias, Bruns, Christiane Josephine, Monig, Stefan P. and Chon, Seung-Hun ORCID: 0000-0002-8923-6428 . Outcome of endoscopic vacuum therapy for duodenal perforation. Surg. Endosc.. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

Background Duodenal defects are complex clinical situations, and their management is challenging and associated with high mortality. Besides surgery, endoscopic treatment options exist, but the size and location of the perforation can limit their application. We present a retrospective study, demonstrating a successful application of endoscopic vacuum therapy (EVT) for duodenal leaks. Methods We performed a retrospective study of all patients who underwent EVT for duodenal perforations between 2016 and 2021 at two tertiary centers. We analyzed demographic and clinical patient characteristics, surgical outcomes, leak characteristics, sponge-related complications, and success rate. Results Indications for treatment with EVT in the duodenum consisted of leak after duodenal suture of a perforated ulcer (n = 4), iatrogenic perforation after endoscopic resection (n = 2), iatrogenic perforation during surgery (n = 2), and anastomotic leak after upper gastrointestinal surgery (n = 2). EVT was used as a first-line treatment in seven patients and as a second-line treatment in three patients. EVT was successfully applied in all interventions (n = 10, 100%). Overall, EVT lead to definitive closure of the defects in eight out of ten patients (80%). No severe EVT-related adverse events occurred. Conclusion EVT is safe and technically feasible, so it emerges as a promising endoscopic treatment option for duodenal leaks. However, multidisciplinary collaboration and management are important to reduce the occurrence of postoperative complications, and to improve recovery rates.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Chevallay, Mickael UNSPECIFIED UNSPECIFIED UNSPECIFIED Lorenz, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bichard, Philippe UNSPECIFIED UNSPECIFIED UNSPECIFIED Frossard, Jean-Louis UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane Josephine UNSPECIFIED UNSPECIFIED UNSPECIFIED Monig, Stefan P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-664970
DOI:	10.1007/s00464-022-09686-w
Journal or Publication Title:	Surg. Endosc.
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ASSISTED CLOSURE; PEPTIC-ULCER; RETROGRADE CHOLANGIOPANCREATOGRAPHY; LAPAROSCOPIC REPAIR; MANAGEMENT; COMPLICATIONS Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66497