Lal Pawanindra, Vindal Anubhav, Hadke N S
Department of Surgery, Maulana Azad Medical College (University of Delhi), and Associated Lok Nayak Hospital, New Delhi, India.
Am J Surg. 2009 Sep;198(3):319-23. doi: 10.1016/j.amjsurg.2008.09.028. Epub 2009 Mar 23.
Giant duodenal ulcer (GDU) perforation remains an extremely uncommon but a rather challenging condition to manage wherein routine surgical procedures are fraught with an extremely high incidence of failure and mortality. It therefore follows that this condition must be identified and managed differently at laparotomy than are most duodenal perforations. We describe a method by which to deal with this condition using triple-tube-ostomy.
In a prospective setting, 20 patients underwent surgery using the technique described in the article. During the same period, 20 patients with GDU perforation, who were managed in the conventional manner, were evaluated. The outcomes of the 2 groups were compared.
The success rate was 100% in the study group compared with 30% in the control patients.
Based on the ease of the technique and the high success of the procedure in our experience in this select group, we recommend this procedure for the management of GDU perforation as a safe, reliable, and easy technique to learn.
巨大十二指肠溃疡（GDU）穿孔仍然极为罕见，但却是一种颇具挑战性的病症，常规手术操作失败率和死亡率极高。因此，在剖腹手术中，这种病症的识别和处理方式必须与大多数十二指肠穿孔不同。我们描述了一种使用三管造口术来处理这种病症的方法。
在一项前瞻性研究中，20例患者采用本文所述技术接受手术。同期，对20例采用传统方式处理的GDU穿孔患者进行评估。比较两组的结果。
研究组成功率为100%，而对照组患者为30%。
基于我们在这一特定群体中的经验，该技术操作简便且成功率高，我们推荐将此手术作为一种安全、可靠且易于学习的技术用于GDU穿孔的处理。
