Mucosa layer obtruding the oesophagojejunostomy: A rare complication after total laparoscopic gastrectomy for gastric cancer

Abstract

The linear-stapled method of esophagojejunostomy is one of the most commonly used techniques to perform laparoscopic intracorporeal anastomosis after gastrectomy. We describe a case of total laparoscopic gastrectomy for gastric cancer. On the first postoperative day, our patient had vomited, so we decided to perform an endoscopy that showed a mucosa layer obtruding the esophagojejunostomy. The only way to solve the situation endoscopically was to perform endoscopic ultrasonography to find the right side to cut the layer, avoiding drilling the esophagus. After the procedure, gastroscopy and barium x-ray demonstrated a perfect resolution of the problem. An endoscopic control 30 months later showed a wide, easily transitable, and scarred esophagojejunostomy, and the patient had no discomfort or problems. We think that this type of anastomosis is safe and feasible. After the complication we described, we usually use a gastric tube to be sure that the mucosa layer was cut making the linear stapler anastomosis.