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Necrosis of gastric remnant following laparoscopic asssisted distal gastrectomy : a case report Tsuyoshi TAKAHASHI 1 , Akihiro TOYOKAWA 1 , Tomoyuki WAKAHARA 1 , Soichiro TANI 1 , Takeshi IWASAKI 1 1Department of Surgery, Yodogawa Christian Hospital Keyword: 腹腔鏡補助下幽門側胃切除術 , 残胃壊死 , 虚血性壊死 pp.613-618
Published Date 2011/10/15
DOI https://doi.org/10.11477/mf.4426100690
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 We report a very rare case of ischemic necrosis of gastric remnant following laparoscopic assisted distal gastrectomy. A 62-year-old man underwent laparoscopic assisted distal gastrectomy for early gastric cancer. On the 3rd postoperative day, emergency laparotomy was required due to intra-abdominal bleeding. On laparotomy, the distal side of gastric remnant was circumferentially necrotic and a bleeding from a small artery on the surface of the pancreas was found. Total gastrectomy was performed along with the hemostasis. Histopathological examination showed venous congestion, ulceration, and tubular atrophic change of the gastric remnant, indicating ischemic necrosis. Because the splenic and short gastric vessels were intact, we postulated that poorly developed intra mural vascular network attributed to the necrosis of the distal part of the gastric remnant. Attention should be made to the individual differences in mural capillary networks to maintain enough blood flow to the gastric remnant.


Copyright © 2011, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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