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Gastric stump

Amador García Ruiz de Gordejuela, Almino Cardoso Ramos, Manoel Galvao Neto, Mario Nora, Antonio J Torres García, Andrés Sánchez Pernaute, Jordi Pujol Gebelli
INTRODUCTION: Live surgery is a topic of interest at every meeting or course in the field of surgery. The potential of laparoscopy for live broadcasting makes it an excellent tool in continuing medical education. Surgeons who participate in live surgeries are usually experienced, but several conditions may influence the results and safety of a procedure. OBJECTIVES: To analyze safety and outcomes in a series of patients who underwent surgery in the last 10 years in a live surgery course at our institution...
March 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Hankun Hao, Jun Hong, Yaping Wang, Jian Wang, Yibing Bei, Luchun Hua
OBJECTIVE: To evaluate the feasibility and the short-term safety of self-pulling and latter transected esophagojejunostomy(SPLT) in totally laparoscopic total gastrectomy (TLTG). METHODS: One hundred patients with gastric cancer received TLTG-SPLT at General Surgery Department of Huashan Hospital (Fudan University) from June 2014 to January 2017(SPLT group). The clinicopathologic characteristics, surgical and postoperative outcomes were collected retrospectively and compared with the conventional group undergoing TLTG plus overlap or functional end-to-end anastomosis from October 2013 to December 2015...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Nan Zhang, Xiangqian Su, Kai Xu
OBJECTIVE: To compare the safety and effectiveness of circular stapler and linear stapler in Billroth II( anastomosis following distal gastrectomy for gastric cancer patients. METHODS: Clinical data of gastric adenocarcinoma patients who received distal gastrectomy with Billroth II( anastomosis at Ward IIII( of Gastrointestinal Cancer Center of Peking University Cancer Hospital from January 2013 to April 2017 were collected retrospectively. EXCLUSION CRITERIA: (1) patients identified as stage IIII( gastric cancer by preoperative clinical and postoperative pathological staging...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Shigeru Fujisaki, Motoi Takashina, Yukari Woo, Ryouichi Tomita, Kenichi Sakurai, Tadatoshi Takayama
We present here a case of transduodenal ampullectomy for an ampullary neoplasm coexisting with gastric and colon cancer. The patient was a 72-year-old man who was referred to our hospital with a positive fecal blood test. Colonoscopy revealed advanced cancer in the descending colon. As part of the preoperative examination, for the colonic cancer, upper gastrointestinal endoscopy was performed. Endoscopy showed a 2 cm elevated lesion(0'-II a type)with subserosalinfil tration on the small curvature side of the upper part of the stomach, and a 2 cm elevated lesion on the papilla of Vater...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
Fu-Hai Ma, Li-Yan Xue, Ying-Tai Chen, Yi-Bin Xie, Yu-Xin Zhong, Quan Xu, Yan-Tao Tian
We herein report a case of neuroendocrine carcinoma of the gastric stump found 47 years after Billroth II gastric resection for a benign gastric ulcer. A 74-year-old man was referred to another hospital with melena. Endoscopic examination revealed a localized ulcerative lesion at the gastrojejunal anastomosis. The diagnosis by endoscopic biopsy was neuroendocrine carcinoma. A total gastrectomy of the remnant stomach with D2 lymphadenectomy was performed at our hospital. The lesion invaded the subserosa, and metastasis was found in two of nine the lymph nodes retrieved...
January 28, 2018: World Journal of Gastroenterology: WJG
Raffaele Dalla Valle, Matteo Rossini, Laura Lamecchi, Maurizio Iaria
Pancreatic fistula (PF) remains the Achilles' heel of pancreaticoduodenectomy (PD). Pancreaticogastrostomy (PG) appears to be associated with a lower risk of postoperative leak according to recent evidence. We started to fashion PG, especially in soft pancreas, modifying the original technique described by Bassi. At our institution, 105 PD procedures were carried out from January 2011 to December 2016; pancreatic-enteric continuity was restored by PG in 35 cases. Superior mesenteric/portal vein resection/reconstruction was necessary in three patients...
January 31, 2018: Updates in Surgery
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
BACKGROUND: Postoperative internal hernia (IH) is a potentially life-threatening acute protrusion of viscus through an iatrogenic mesenteric defect. In our retrospective study of 1943 consecutive gastric cancer (GC) patients who had undergone surgery, the incidence of IH after laparoscopic total gastrectomy (LTG) was 4.9%.1 This high incidence seems to be caused by decreased adhesion formation after LTG. There is no consensus regarding orifice management during robotic total gastrectomy (RTG)...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Min Chan Kim, Sang Yun Kim, Kwan Woo Kim
Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months...
December 2017: Journal of Gastric Cancer
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Sang Yun Kim, So Hyun Nam, Jae Seok Min, Min Chan Kim
Purpose: Duodenal stump fistula (DSF) is a serious complication after gastrectomy for gastric cancer. Although risk evaluation and management of DSF were presented by some investigators, there was no technical attempt has been made to prevent DSF during laparoscopic gastrectomy until now. Methods: Consecutive 99 patients were enrolled from April 2014 to February 2016 in 2 institutes. All patients were performed laparoscopic gastrectomy for gastric cancer. After cutting of duodenal stump, laparoscopic reinforcement suture (LARS) commenced with continuous invagination method or interrupted method by barbed suture...
December 2017: Annals of Surgical Treatment and Research
Morgane Bouquot, Safi Dokmak, Louise Barbier, Jérôme Cros, Philippe Levy, Alain Sauvanet
BACKGROUND: Gastric stump carcinoma is an exceptional and poorly known long-term complication after pancreaticoduodenectomy. CASES PRESENTATION: Two patients developed gastric stump carcinoma 19 and 10 years after pancreaticoduodenectomy for malignant ampulloma and total pancreaticoduodenectomy for pancreatic adenocarcinoma, respectively. Both patients had pT4 signet-ring cell carcinoma involving the gastrojejunostomy site that was revealed by bleeding or obstruction...
November 22, 2017: BMC Gastroenterology
Javier Bueno, Rosa Burgos, Susana Redecillas, Manuel López, Joaquin Balsells
BACKGROUND: We have recently demonstrated the feasibility of lengthening the duodenum in children with short bowel syndrome and a dilated duodenum. This procedure gains additional intestinal length in a challenging area of autologous gut reconstruction. Herein, we report the successful application of this technique in an adult with ultra-short bowel syndrome. METHODS: A 25-year-old man with a history of mid-gut volvulus was referred to our center for intestinal transplant evaluation...
November 6, 2017: Revista Española de Enfermedades Digestivas
Ayman El Nakeeb, Ahmad M Sultan, Ehab Atef, Ali Salem, Mostaffa Abu Zeid, Ahmed Abu El Eneen, Gamal El Ebidy, Mohamed Abdel Wahab
BACKGROUND: Pancreatic reconstruction following pancreaticoduodenectomy (PD) is still debatable even for pancreatic surgeons. Ideally, pancreatic reconstruction after PD should reduce the risk of postoperative pancreatic fistula (POPF) and its severity if developed with preservation of both exocrine and endocrine pancreatic functions. It must be tailored to control the morbidity linked to the type of reconstruction. This study was to show the best type of pancreatic reconstruction according to the characters of pancreatic stump...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Tabish Chawla, Hassaan Bari, Shahrukh Effendi
Whipple's pancreaticoduodenectomy has been refined over the years to be a safe operation though the morbidity rate still remains high (30-50%). Pancreatic fistula is the most important cause of mortality following pancreaticoduodenectomy. To prevent it, surgeons have used two anastomotic techniques: pancreaticojejunostomy and pancreaticogastrostomy. Recent studies found that pancreaticogastrostomy is associated with fewer overall complications than pancreaticojejunostomy. This is a retrospective review of patients who underwent Whipple's at Aga Khan University Hospital and had pancreaticogastrostomy as a preferred anastomosis for pancreatic stump...
October 2017: JPMA. the Journal of the Pakistan Medical Association
Yayoi Sakatoku, Masahide Fukaya, Hironori Fujieda, Yuzuru Kamei, Akihiro Hirata, Keita Itatsu, Masato Nagino
BACKGROUND: Tracheoesophageal fistula (TEF) is a rare but life-threatening complication after esophagectomy. It has a high mortality rate and often leads to severe aspiration pneumonia. Various types of surgical repair procedures have been reported, but the optimal management of TEF is challenging and controversial. Treatment should be individualized to each patient. CASE PRESENTATION: A 66-year-old female underwent transthoracic esophagectomy with gastric tube reconstruction and an intrathoracic anastomosis for esophageal cancer...
August 23, 2017: Surgical Case Reports
Hua-Long Zheng, Jun Lu, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Mi Lin, Ru-Hong Tu, Chang-Ming Huang
OBJECTIVE: The aim of this study was to compare the short- and long-term outcomes of malnourished gastric cancer patients who underwent laparoscopic or open radical gastrectomy. BACKGROUND: Preoperative malnutrition is an independent risk factor for postoperative mortality and morbidity in major gastrointestinal surgery. However, whether laparoscopic surgery can improve the short- and long-term outcomes of malnourished gastric cancer patients has not been determined...
July 24, 2017: World Journal of Surgery
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
Junjie Xing, Chenxin Zhang, Xiaohong Yang, Hao Wang, Hantao Wang, Enda Yu, Chuangang Fu
OBJECTIVE: To compare the short-term outcomes between transrectal specimen extraction during laparoscopic sigmoid radical resection and conventional laparoscopy-assisted sigmoid radical resection. METHODS: Sixteen patients(transrectal specimen extraction group,4 females and 12 males), who were planned to undergo laparoscopically assisted sigmoid radical resection with BMI<28 kg/m(2) and were evaluated as T1-T3 tumor by iconography without distant metastasis, were selected to undergo transrectal specimen extraction during laparoscopic sigmoid radical resection from December 2015 to April 2016 in the Department of Anorectal Surgery of Changhai Hospital...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Massimo Tonolini, Elena Bracchi
Surgical resection represents the mainstay treatment and only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Furthermore, other tumours and selected cases of non-malignant disorders of the stomach may require partial or total gastrectomy. Often performed in elderly patients, gastric resection remains a challenging procedure, with significant morbidity (14-43% complication rate) and non-negligible postoperative mortality (approximately 3%). This paper provides an overview of contemporary surgical techniques for non-bariatric gastric resection, reviews and illustrates the expected postoperative imaging appearances, common and unusual complications after partial and total gastrectomy...
August 2017: Insights Into Imaging
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