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Leakage of jejunal end of roux limb after total gastrectomy: management with a placement of a covered metallic stent: case report
Authors:Cho Yong Pil  Lee Deok Hee  Jang Hyuk Jai  Kim Jee Soo  Kim Yong Ho  Han Myoung Sik  Lee Sung Gyu
Institution:Department of Surgery and Diagnostic Radiology, University of Ulsan Medical College, Gangneung Asan Hospital, Gangneung-si, Seoul, Korea. ypcho@gnah.co.kr
Abstract:Postoperative leakage is a serious complication in patients after gastric surgery. It can lead to a rapid deterioration in the patient's condition and quality of life. Treatment is guided by the type of anastomosis and the patient's clinical status. The role of interventional radiology in gastrointestinal tract is evolving. Metallic stent placement has shown encouraging results for the palliation of gastrointestinal tract obstruction and fistula in malignant patients. We encountered a case of the leakage of jejunal end of Roux limb after total gastrectomy. This patient required a drainage procedure with long-term parenteral nutrition. We performed peroral placement of a covered metallic stent to avoid surgery and long-term parenteral nutrition, and he resumed adequate oral intake immediately after stent placement. This minimally invasive procedure is very promising for the treatment of a gastrointestinal fistula to avoid surgery and long-term parenteral nutritional support in selected cases.
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