RELIABLE PROCEDURE FOR CLOSING THE DUODENAL STUMP FOR BLEEDING POSTERIOR DUODENAL-ULCER

Bleeding posterior duodenal ulcers is a critical problem especially in patients of advanced age. Surgical treatment should obtain efficient and stable hemostasis and avoid digestive fistulas due to leakage of t he duodenal stump. The main difficulty lies in the closure of the duod enal stump. A procedure using intramural dissection of the duodenum an d closure by means of a stapler is reported for a series of 40 patient s without recurrent bleeding or duodenal fistula. Seven patients (17%) died from associated diseases, especially respiratory insufficiency ( 3 patients) and cirrhotic liver failure (2 patients).