Cargando…

Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report

Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy. A 58-year-old man with drug-in...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Yeo Jin, Kim, Dae Hoon, Choi, Hanlim, Ryu, Dong Hee, Yun, Hyo Yung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259114/
https://www.ncbi.nlm.nih.gov/pubmed/35801737
http://dx.doi.org/10.1097/MD.0000000000029732
_version_ 1784741702075940864
author Kim, Yeo Jin
Kim, Dae Hoon
Choi, Hanlim
Ryu, Dong Hee
Yun, Hyo Yung
author_facet Kim, Yeo Jin
Kim, Dae Hoon
Choi, Hanlim
Ryu, Dong Hee
Yun, Hyo Yung
author_sort Kim, Yeo Jin
collection PubMed
description Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy. A 58-year-old man with drug-induced liver cirrhosis (Child-Pugh class A) underwent laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer. On postoperative day 1, he underwent reoperation because of intra-abdominal bleeding. Ongoing bleeding was observed in the stapler line of the duodenal stump and was controlled using metallic surgical clips. The patient was discharged on postoperative day 14, without complications. After 144 days following the first operation, he visited the emergency room with right flank pain and high fever. Computed tomography revealed free air and abscess near the duodenal stump site. Emergency laparotomy, abscess unlooping, and drain insertion were performed. After surgery, bile was drained by intra-abdominal drainage, and fistulography showed a duodenal fistula. The patient was discharged 55 days after his third surgery. This is an extremely rare case of DSF, which may be caused by the metallic surgical clips used for hemostasis of the duodenal stump stapler line. We believe that the use of metallic surgical clips for hemostasis of the duodenal stump after Billroth-II reconstruction should be avoided.
format Online
Article
Text
id pubmed-9259114
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-92591142022-07-08 Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report Kim, Yeo Jin Kim, Dae Hoon Choi, Hanlim Ryu, Dong Hee Yun, Hyo Yung Medicine (Baltimore) Research Article Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy. A 58-year-old man with drug-induced liver cirrhosis (Child-Pugh class A) underwent laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer. On postoperative day 1, he underwent reoperation because of intra-abdominal bleeding. Ongoing bleeding was observed in the stapler line of the duodenal stump and was controlled using metallic surgical clips. The patient was discharged on postoperative day 14, without complications. After 144 days following the first operation, he visited the emergency room with right flank pain and high fever. Computed tomography revealed free air and abscess near the duodenal stump site. Emergency laparotomy, abscess unlooping, and drain insertion were performed. After surgery, bile was drained by intra-abdominal drainage, and fistulography showed a duodenal fistula. The patient was discharged 55 days after his third surgery. This is an extremely rare case of DSF, which may be caused by the metallic surgical clips used for hemostasis of the duodenal stump stapler line. We believe that the use of metallic surgical clips for hemostasis of the duodenal stump after Billroth-II reconstruction should be avoided. Lippincott Williams & Wilkins 2022-07-08 /pmc/articles/PMC9259114/ /pubmed/35801737 http://dx.doi.org/10.1097/MD.0000000000029732 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kim, Yeo Jin
Kim, Dae Hoon
Choi, Hanlim
Ryu, Dong Hee
Yun, Hyo Yung
Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
title Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
title_full Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
title_fullStr Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
title_full_unstemmed Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
title_short Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
title_sort delayed duodenal stump fistula after laparoscopic distal gastrectomy with billroth-ii reconstruction for early gastric cancer: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259114/
https://www.ncbi.nlm.nih.gov/pubmed/35801737
http://dx.doi.org/10.1097/MD.0000000000029732
work_keys_str_mv AT kimyeojin delayedduodenalstumpfistulaafterlaparoscopicdistalgastrectomywithbillrothiireconstructionforearlygastriccanceracasereport
AT kimdaehoon delayedduodenalstumpfistulaafterlaparoscopicdistalgastrectomywithbillrothiireconstructionforearlygastriccanceracasereport
AT choihanlim delayedduodenalstumpfistulaafterlaparoscopicdistalgastrectomywithbillrothiireconstructionforearlygastriccanceracasereport
AT ryudonghee delayedduodenalstumpfistulaafterlaparoscopicdistalgastrectomywithbillrothiireconstructionforearlygastriccanceracasereport
AT yunhyoyung delayedduodenalstumpfistulaafterlaparoscopicdistalgastrectomywithbillrothiireconstructionforearlygastriccanceracasereport