[Suture insufficiency following BI-resection (author's transl)]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Context:

• Billroth I resection is a surgical procedure for gastric conditions.
• Suture insufficiency is a potential complication following gastrointestinal surgery.
• Understanding the incidence and diagnosis of suture insufficiency is crucial for patient outcomes.

Purpose:

• To investigate the incidence, diagnosis, and management of suture insufficiency after Billroth I resection.
• To evaluate the utility of clinical criteria and radiographic findings in diagnosing early and late suture insufficiency.
• To outline treatment strategies for different phases of suture insufficiency.

Summary:

• Suture insufficiency developed in 33 of 135 patients (24.5%) undergoing Billroth I resection, irrespective of surgical urgency.
• Early diagnosis can be challenging with direct radiography, but indirect signs like gastroatonia, delayed gastric emptying, and left-sided pleural effusion are valuable.
• Early insufficiency (days 1-3) necessitates immediate relaparotomy, while late insufficiency (days 4-6) can often be treated conservatively with adequate drainage.

Impact:

• This study highlights the significant incidence of suture insufficiency post-Billroth I resection.
• It provides a diagnostic framework utilizing clinical and indirect radiographic findings.
• Effective management strategies, differentiating between early and late insufficiency, can improve patient recovery and reduce complications like prolonged hospitalization and hemorrhage.