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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2022; 14(11): 1285-1296
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1285
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1285
Disturbed passage of jejunal limb near esophageal hiatus after overlapped esophagojejunostomy following laparoscopic total gastrectomy
Hirokazu Noshiro, Yukie Yoda, Department of Surgery, Saga University Faculty of Medicine, Saga 849-8501, Japan
Keiichiro Okuyama, Department of Surgery, Saga University, Saga 849-8501, Japan
Author contributions: Noshiro H contributed to conceptualization, methodology, formal analysis, investigation, writing-original draft, writing-review & editing; Okuyama K contributed to writing-review & editing; Yoda Y contributed to investigation; All authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of Saga University Hospital (Approval No. 2020-05-R-02).
Informed consent statement: Informed written consent was obtained from the patient and her family for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hirokazu Noshiro, FACS, MD, PhD, Professor, Surgeon, Department of Surgery, Saga University Faculty of Medicine, Nabeshima 5-1-1, Saga 849-8501, Japan. noshiro@cc.saga-u.ac.jp
Received: July 25, 2022
Peer-review started: July 25, 2022
First decision: September 4, 2022
Revised: September 16, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 27, 2022
Peer-review started: July 25, 2022
First decision: September 4, 2022
Revised: September 16, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 27, 2022
Core Tip
Core Tip: Overlapped esophagojejunostomy (OEJ) is a secure purely laparoscopic reconstruction after laparoscopic total gastrectomy (LTG). However, disturbed passage through the jejunal limb near the esophageal hiatus can occur. In this paper, mechanisms and prevention for this complication are described. Five patients (2.4%) had disturbed oral intake and marked weight loss, all had unusual jejunal limb stricture after LTG and OEJ. Reoperation for adhesiolysis and division of the left crus and rearrangement of the jejunal limb was required. Prevention for this complication is possible during the original LTG procedure.