[Duodenal injuries]

Experience in surgical treatment of 69 patients with open (41) and closed (28) injuries to the duodenum (D) is analysed. The wound (rupture) was closed with sutures in 52 patients, closure of the wound was supplemented by gastroenterostomy in 9 patients, other variants of treatment were applied in 8 patients. In 7 patients the damage of the D was not detected during the first operation. Complications developed in 34.8% of cases, mortality was 27.5%. A diagnostic algorithm is suggested which includes along with clinical examination, successive radioscopy (-graphy), laparocentesis or laparoscopy, and fibrogastroduodenoscopy. The therapeutic and diagnostic program included intraoperative transcatheter pneumopressure, standardized operative variants with the use of precision suture techniques, and decompressive drainage of the D with a fixed catheter. As a result the number of complications reduced by 1.5 times and lethality by half. The late-term results were studied in 26 patients, they were found to be good in 21 of them.