World journal of surgery
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World journal of surgery · Nov 1993
Pyloric exclusion in severe penetrating injuries of the duodenum.
This study comprises 74 patients with penetrating injuries of the duodenum. Sixty-three of these had sustained gunshot wounds, many of which were high velocity. The change in the incidence and the severity of the gunshot injuries within the last few years resulted in changes in the operative management of the duodenal wound with gradually improving results. ⋯ When only primary repair was done, the leakage rate was 43%. We suggest that pyloric exclusion be added to the treatment of most severe grade II and all grade III gunshot duodenal injuries. The adequacy of primary repair and pyloric exclusion in grade IV injuries requires further study.