Multidisciplinary management of postoperative duodenal perforation using multiple drainage and stenting: A case report and review of literature

doi:10.4240/wjgs.123036

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Oct 27, 2026; 18(10): 123036
Published online Oct 27, 2026. doi: 10.4240/wjgs.123036

Multidisciplinary management of postoperative duodenal perforation using multiple drainage and stenting: A case report and review of literature

Liang-Bo Dong, Meng-Wei Wu, Jia-Shu Han, Chen Lin, Wei-Bin Wang

Liang-Bo Dong, Jia-Shu Han, Chen Lin, Wei-Bin Wang, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Meng-Wei Wu, Department of Hepatobiliary Surgery, Xiamen Translational Medical Key Laboratory of Digestive System Tumor, Fujian Provincial Key Laboratory of Chronic Liver Disease and Hepatocellular Carcinoma, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, Fujian Province, China

Co-first authors: Liang-Bo Dong and Meng-Wei Wu.

Co-corresponding authors: Chen Lin and Wei-Bin Wang.

Author contributions: Dong LB, Wu MW, and Han JS reviewed related literature and drafted the manuscript; Dong LB and Wu MW contributed equally to this manuscript and are co-first authors; Lin C and Wang WB directed and guided the study, and they contributed equally to this manuscript and are co-corresponding authors. All authors have read and approved the final manuscript.

AI contribution statement: In this study, only Claude (Anthropic) and Doubao (ByteDance) were used for limited editorial assistance. AI was exclusively applied for language polishing and English translation of the authors’ original manuscript and reviewer responses. The main text, including abstract, introduction, case presentation, discussion, and conclusion, was fully authored by the researchers based on authentic clinical data. AI was not involved in study design, clinical management, data analysis, or result interpretation. All figures are original clinical images and author-made illustrations without AI generation or modification. The authors take full responsibility for the originality, accuracy, and scientific validity of this work.

Supported by National Natural Science Foundation of China, No. 82573412; and Peking Union Medical College Hospital Talent Cultivation Program (Category B), No. UGG04598.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Wei-Bin Wang, MD, PhD, Professor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China. wwb_xh@163.com

Received: May 8, 2026
Revised: June 1, 2026
Accepted: June 25, 2026
Published online: October 27, 2026
Processing time: 158 Days and 22.3 Hours

Abstract

BACKGROUND

Duodenal perforation is a severe postoperative complication with a high mortality rate of 30%-40%. Causes include ulcers, trauma, and surgical separation. Early diagnosis via computed tomography and timely intervention are crucial. Treatment varies, with conservative methods such as stenting or surgery used for critical cases. Larger perforations may require reconstructive surgery. In this case, a tailored approach including biliary diversion, stenting, placement of a duodenostomy tube, and negative pressure irrigation led to no recurrence and smooth recovery.

CASE SUMMARY

This report describes the clinical course and management of a patient who developed a duodenal perforation 9 days after resection of a retroperitoneal mass. Through timely intervention and a multidisciplinary approach, the patient experienced a favorable prognosis and recovery. Key interventions included restructuring and patching, intestinal decompression, stenting, and drainage. Crucially, stenting, drainage, and negative pressure irrigation played a pivotal role in diluting digestive secretions and providing localized protection. These measures significantly expedited the closure of the perforation and facilitated the patient's recovery.

CONCLUSION

This case highlights the need for individualized multidisciplinary treatment to attenuate duodenal leakage and ensure smooth recovery.

Keywords: Duodenal perforation; Postoperative complication; Multidisciplinary management; Stent graft; Multiple drainage; Case report

Core Tip: Few studies have reported successful stent graft implantation in duodenal perforation. In this case, we adopted the quadruple drainage method to decompress the duodenum and achieved good results. The treatment process was long and the condition was complicated. Almost all treatment methods for duodenal perforation were used in combination, and multiple critical situations were successfully resolved. This report describes a typical case of postoperative duodenal perforation treatment.