Retro-anastomotic hernia eight cases of internal hernia following gastrojejunal anastomosis with a review of the literature

Bastable, J. R. G.; Huddy, P. E.

doi:10.1002/bjs.18004820821

Cited by 21 publications

(6 citation statements)

References 27 publications

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“…In some patients, the condition can be rapidly complicated by the development of perforation/peritonitis and can result in death. Therefore, early diagnosis and immediate surgical therapy are necessary to decrease the high mortality rate—reported to range from 30 to 60%—associated with this complication [5, 6]. The incidence of this complication after Billroth II distal gastrectomy has been reported to be 0.3–1.0% [2, 6, 7].…”

Section: Introductionmentioning

confidence: 99%

Afferent Loop Obstruction After Distal Gastrectomy with Roux‐en‐Y Reconstruction

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Afferent Loop Obstruction After Distal Gastrectomy with Roux‐en‐Y Reconstruction

et al. 2010

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“…Mortality from these complications has been reported to be 30% to 60%. 22,23 Therefore, early diagnosis is important, and proper surgical treatment is strongly recommended in order to prevent worsening of the patient's condition. 24,25 Traditionally, surgery has been the treatment of choice for ALS.…”

Section: Discussionmentioning

confidence: 99%

Role of Percutaneous Transhepatic Biliary Drainage in Patients With Complications After Gastrectomy

Kim

Lee

Kim

et al. 2016

International Surgery

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The aim of this study was to elucidate the role of percutaneous transhepatic biliary drainage (PTBD) in patients with duodenal stump leakage (DSL) and afference loop syndrome (ALS) postgastrectomy for malignancy or benign ulcer perforation. Percutaneous transhepatic biliary drainage (PTBD) is an interventional radiologic procedure used to promote bile drainage. Duodenal stump leakage (DSL) and afferent loop syndrome (ALS) can be serious complications after gastrectomy. From January 2002 through December 2014, we retrospectively reviewed 19 patients who underwent PTBD secondary to DSL and ALS postgastrectomy. In this study, a PTBD tube was placed in the proximal duodenum near the stump or distal duodenum in order to decompress and drain bile and pancreatic fluids. Nine patients with DSL and 10 patients with ALS underwent PTBD. The mean hospital stay was 34.3 days (range, 12 to 71) in DSL group and 16.4 days (range, 6 to 48) in ALS group after PTBD. A liquid or soft diet was started within 2.6 days (range, 1 to 7) in the ALS group and within 3.4 days (range, 0 to 15) in the DSL group after PTBD. One patient with DSL had PTBD changed, and 2 patients with ALS underwent additional surgical interventions after PTBD. The PTBD procedure, during which the tube was inserted into the duodenum, was well-suited for decompression of the duodenum as well as for drainage of bile and pancreatic fluids. This procedure can be an alternative treatment for cases of DSL and ALS postgastrectomy.Key words: Gastrectomy -PTBD -Duodenal stump leakage -Afferent loop syndrome P ostoperative complications after gastrectomy are difficult for both patients and surgeons. In the past, most of the major complications after gastrectomy required re-operation. The rate of reoperation for these complications ranges from 2.8% to 10%. 1-3 After gastrectomy, duodenal stump leak-

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“…In our results, there were no candidates for these alternative methods. The reported mortality rate associated with A-loop obstructions is high (30-60%) [4,16]. Most of these high mortality rates were reported before the development of CT scan or ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

“…A-loop obstruction develops acutely, and its onset can be early or late postoperatively [2]. In some patients, the condition can be rapidly complicated by the development of duodenal stump leakage or perforation followed by peritonitis and can result in sepsis [3,4]. Therefore, early diagnosis and immediate surgical therapy are mandatory to decrease the high mortality rate associated with this complication.…”

Section: Introductionmentioning

confidence: 99%

Afferent loop obstruction following laparoscopic distal gastrectomy with Billroth-II gastrojejunostomy

2013

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PurposeAfferent loop (A-loop) obstruction is an uncommon postgastrectomy complication following Billroth-II (B-II) or Roux-en-Y reconstruction. Moreover, its development after laparoscopic gastrectomy has not been reported. Here we report 4 cases of A-loop obstructions after laparoscopic distal gastrectomy (LDG) with B-II reconstruction.MethodsAmong the 396 patients who underwent LDG with a B-II anastomosis between April 2004 and December 2011, 4 patients had A-loop obstruction. Their data were obtained from a prospectively maintained institutional database and analyzed for outcomes.ResultsFour patients (1.01%) developed A-loop obstruction. All were male, and their median age was 52 years (range, 30 to 73 years). The interval between the initial gastrectomies and the operation for A-loop obstruction ranged from 4 to 540 days (median, 33 days). All 4 patients had symptoms of vomiting and abdominal pain and were diagnosed by abdominal computed tomographic (CT) scan. The causes of the A-loop obstructions were adhesions (2 cases) and internal herniations (2 cases) that were treated with Braun anastomoses and reduction of the herniated small bowels, respectively. All patients recovered following the emergency operations.ConclusionA-loop obstruction is a rare but serious complication following laparoscopic and open gastrectomy. It should be considered when a patient complains of continuous abdominal pain and/or vomiting after LDG with B-II reconstruction. Prompt CT scan may play an important role in diagnosis and treatment.

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Retro-anastomotic hernia eight cases of internal hernia following gastrojejunal anastomosis with a review of the literature

Cited by 21 publications

References 27 publications

Afferent Loop Obstruction After Distal Gastrectomy with Roux‐en‐Y Reconstruction

Afferent Loop Obstruction After Distal Gastrectomy with Roux‐en‐Y Reconstruction

Role of Percutaneous Transhepatic Biliary Drainage in Patients With Complications After Gastrectomy

Afferent loop obstruction following laparoscopic distal gastrectomy with Billroth-II gastrojejunostomy

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