위전절제술에 합병된 문합부 누출의 스텐트 삽입술을 이용한 치료 1예 |
박자인ㆍ박종재ㆍ오주연ㆍ이원우ㆍ조혜진ㆍ문재영ㆍ김재선ㆍ박영태 |
고려대학교 의과대학 구로병원 소화기내과학교실 |
A Case of Endoscopic Stenting for Anastomotic Leakage after Total Gastrectomy |
Ja In Park, M.D., Jong Jae Park, M.D., Joo Yeon Oh, M.D., Won Woo Lee, M.D., Hye Jin Cho, M.D., Jae Young Moon, M.D., Jae Seon Kim, M.D. and Young Tae Bak, M.D. |
Department of Gastroenterology, Korea University College of Medicine, Medical Center, Guro Hospital, Seoul, Korea |
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Abstract |
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Anastomotic leakage after gastrectomy has significant morbidity and mortality, and the mortality rate has been reported to be over 60%. There have been very few reports concerning endoscopic stenting for the management of anastomotic leakage. Successful treatment of anastomotic leakage with covered self-expanding metallic stents (stent) has recently been reported. A 62-year-old man with melena was diagnosed with advanced gastric cancer and he underwent total gastrectomy. At the 3rd day after surgery, anastomotic leakage was found by an upper gastrointestinal series (UGI). He underwent laparoscopic primary repair on the 5th day after surgery. The leakage resumed thereafter. At the 12th day after the primary repair, the leakage was successfully managed by stent insertion and the patient improved thereafter. At the 11th week after stent insertion, the stent was removed without complications and the leakage was completely closed. At 1 year after stent removal, no stricture has been found on the anastomosis site. We report here on a case of anastomotic leakage after gastrectomy, and this was completely managed by stent insertion. (Korean J Gastrointest Endosc 2009;39:369-373) |
Key Words:
Postoperative complication, Stents, Gastrectomy |
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