Bailout tube duodenostomy is a safe strategy with favourable outcomes in the management of hostile nonsalvageable perforated duodenal ulcer (moderate certainty). Although comparative evidence is lacking, it may be considered as an alternative to bypass surgery, which is associated with longer operative time and high risks of morbidity in the presence of peritoneal contamination, sepsis and haemodynamic instability.
Saji et al. (2026) studied this question.