Risk Factors Of Duodenal Stump Leakage After Laparoscopic Gastrectomy For Gastric Cancer

Background:Duodenal stump leakage(DSL)is one of the fatal complications after gastrectomy,but its risk factors are not clear.The purpose of this study was to investigate the incidence and risk factors of DSL after laparoscopic radical gastrectomy for gastric cancer(GC).Methods:Relevant data were collected from prospective databases to retrospectively analyze the data of GC patients who underwent Billroth II(B-II)and Roux-en-Y(R-Y)reconstruction after laparoscopic gastrectomy at two institutions(Sir Run Run Shaw Hospital,Zhejiang University School of Medicine and Hwa Mei Hospital,University of Chinese Academy of Sciences,).The risk factors of DSL were analyzed by univariate and multivariate analysis regression.Results:Finally,810 patients were eligible for our analysis(384 patients with R-Y and426 patients with B-II[B-II with Braun]).A total of 11 patients with DSL(1.36%)were observed.BMI,preoperative C-reactive protein(CRP),and reinforcement of duodenal stump were the independent risk factors for DSL.The diagnosis time of DSL was 2-12 days,with a median of 8days.Seven patients received conservative treatment,three patients received puncture treatment,and only one patient underwent reoperation.All patients recovered after treatment without death.Conclusions:The risk factors of DSL were BMI≥24kg/m~2,elevated preoperative CRP,and unreinforced duodenal stump.