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...
Autores principales: | , , , , |
---|---|
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 |