关键词: 十二指肠残端瘘, 胃手术, 危险因素, 诊治

Abstract: Duodenal stump fistula is a common and severe complication following gastrectomy, particularly prevalent after Billroth-Ⅱ and Roux-en-Y reconstruction. Clinical manifestations include epigastric pain, fever, and tachycardia, with severe cases progressing to life-threatening complications such as peritonitis, intra-abdominal infection, and shock. Diagnosis relies on imaging modalities, including CT and ultrasonography. Risk factors encompass age, sex, malnutrition, hypoalbuminemia, cirrhosis, as well as tumor location in gastric cancer. Notably, tumors involving the gastric antrum and pylorus are more prone to inducing stump fistula. Timely diagnosis and appropriate intervention are crucial for duodenal stump fistula. Mild cases may be managed solely with conservative treatment, such as fasting, gastrointestinal decompression, antibiotics, and nutritional support, while severe cases require surgical intervention. Endoscopic approaches are particularly beneficial for small, non-infected fistulas, offering a minimally invasive alternative to surgery, whereas open surgical intervention is reserved for advanced cases. Although the incidence of duodenal stump fistula is relatively low, improper management can lead to catastrophic outcomes. Therefore, tailored treatment plans based on individual patient profiles are essential to optimize therapeutic efficacy and improve prognosis.

Key words: duodenal stump fistula, gastric surgery, risk factors, diagnosis and treatment