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- Title
Anastomotic recurrence after laparoscopic distal gastrectomy with delta-shaped anastomosis: report of a case.
- Authors
Daichi Ishikawa; Kozo Yoshikawa; Jun Higashijima; Masaaki Nishi; Hideya Kashihara; Chie Takasu; Mitsuo Shimada
- Abstract
Delta-shaped anastomosis is nowadays an increasingly performed reconstruction method in laparoscopic distal gastrectomy for early gastric cancer. To date, anastomotic recurrence at the delta-shaped anastomotic site has not been reported. Surgery for this disease is more complicated than anastomotic recurrence at the site of conventional Billroth-I anastomosis. A 68-year-old female was referred to our institute with early gastric cancer on the posterior wall of the antrum. She underwent laparoscopic distal gastrectomy with delta- shaped Billroth-I anastomosis. Follow-up gastrofiberscopy 16 months after the operation revealed suspected anastomotic recurrence, and gastric biopsy revealed signet-ring cell carcinoma. Open total gastrectomy with reconstruction with the Roux-en-Y method was performed. At the distal part of the previous anastomosis, an adequate length of the duodenum was dissected from the pancreas. Then, the duodenum was transected 3 cm distal to the anastomosis using a linear stapler. The patient recovered well and was discharged on postoperative day 14. The patient is alive without re-recurrence 3 years postoperatively. We successfully treated a patient with anastomotic recurrence of gastric cancer after delta-shaped anastomosis. Adequate resection of the duodenal stump was performed without any residual tumor or injury to the pancreas.
- Subjects
GASTRECTOMY; SURGICAL anastomosis; DUODENUM; STOMACH biopsy; STOMACH surgery
- Publication
Journal of Medical Investigation, 2020, Vol 67, Issue 1/2, p211
- ISSN
1343-1420
- Publication type
Case Study
- DOI
10.2152/jmi.67.211