No abstract available.
Gastric Stump*

No abstract available.
Gastric Stump*

Many studies have shown that gastric stump cancer develops after distal gastrectomy, particularly after Billroth II reconstruction. But, recurrent cancer at the duodenal stump following Billroth II type distal gastrectomy for gastric cancer is extremely rare. We report a case of duodenal stump cancer in a 64-year-old man underwent Billroth II distal gastrectomy.
Gastrectomy ; Gastric Stump ; Gastroenterostomy ; Humans ; Middle Aged ; Recurrence ; Stomach Neoplasms

Gastric stump cancer is defined as cancers that develop in the gastric remnant after the gastric resection of nonmalignant lesions or malignant lesions. The interval between gastrectomy and the detection of gastric stump cancer must be over 5 years in nonmaligant lesions and 10 years in malignant lesions. Symptoms of gastric stump cancer are not specific, so, diagnosis is often delayed. Early detection and curative operation is very important in gasric stump cancer and follow-up endoscopic examination is the most importaint diagnostic tool to detect gastric stump cancer. Recently we experienced a case of early gastric stump cancer. We report review of the literature to remind the important of gastric stump cancer and the important of follow-up endoscopic examination.
Diagnosis ; Esophagus* ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Intestines* ; Stomach*

In Korea, proximal gastrectomy has recently attracted attention as a better choice of function-preserving surgery for proximal early gastric cancer than total gastrectomy. Of the various strategies to overcome reflux symptoms from remnant stomach, double tract reconstruction not only reduces the incidence of anastomosis-related complications, but is also sufficiently reproducible as a laparoscopic procedure. Catching up with the recent rise of single-port laparoscopic surgeries, we performed a pure single-port laparoscopic proximal gastrectomy with DTR. This procedure was designed by merging the function-preserving concept of proximal gastrectomy with single-port laparoscopic total gastrectomy.
Gastrectomy* ; Gastric Stump ; Incidence ; Korea ; Laparoscopy ; Stomach Neoplasms*

Obesity is one of the most significant causes of GERD. Nissen fundoplication is a surgical procedure that's performed world widely for treating patients with GERD and a hiatal hernia and who are intractable to medical therapy. However, Nissen fundoplication may have technical difficulties in morbidly obese patients due to the huge perigastric, intraabdominal fat tissue and hepatomegaly. During the laparoscopic Roux-en-Y Gastric Bypass (LRYGB) procedure, the stomach was divided into the gastric pouch and the remnant stomach by vertiacally stapling at the angle of His. The posterior gastric wall and hiatus were easily exposed even when there was huge deposits of perigatric and intraabdominal fat tissue. We report here on a case of concomitant hiatal hernia repair with LRYGB in a morbidly obese patient.
Fundoplication ; Gastric Bypass ; Gastric Stump ; Gastroesophageal Reflux ; Hepatomegaly ; Hernia, Hiatal ; Humans ; Obesity ; Obesity, Morbid ; Stomach

Cancer of the gastric stump, first described by Balfour in 1922, is defined as the cancer detected more than 5 years after surgery for a benign disease. We experienced a case of cancer found at the gastric stump after gastrojejunostomy in a 53 years old male patients, proven pathologically as a early cancer. He visited to our hospital with the chief complaint of epigastric pain and indigestion for 1 Months. On past history, he has been received gastrojejunostomy due to duodenal ulcer obstruction, 23 years ago, Gastrofiberscopy was done, and we could find the early gastric cancer lesions at the anterior wall of gastric angle as type Ilc+III and antrum as type IIa. The microscopic finding of the multiple endoscopic biopsies at the gastic angle and antrum revealed the adenocarcinoma of signet ring cell type infiltrated to the level of submucosa. And so, we could diagnose these lesions as a early gastric cancer in the gastric stump after gastrojejunostomy. He was treated with subtotal gastrectomy and discharged with cured condition. Therefore, we report this case with a literature review.
Adenocarcinoma ; Biopsy ; Duodenal Ulcer* ; Dyspepsia ; Gastrectomy ; Gastric Bypass* ; Gastric Stump* ; Humans ; Male ; Middle Aged ; Stomach Neoplasms

PURPOSE: An uncut Roux-en-Y gastrojejunostomy has been known to be effective in preventing bile reflux gastritis in the remnant stomach and the Roux stasis syndrome. MATERIALS AND METHODS: To evaluate the usefulness of a totally laparoscopic uncut Roux-en-Y gastrojejunostomy (TLuRYGJ) after a distal gastrectomy, we reviewed the medical records of 19 consecutive patients that underwent a TLuRYGJ at our institution, and 11 consecutive patients who underwent a totally laparoscopic Billroth I gastrectomy (TLB-I) during the same period. RESULTS: Postoperative gastrointestinal symptoms related to the postgastrectomy syndrome and the Visick classification at six months after surgery were not different in the two groups; however, there was no case of symptomatic bile reflux gastritis and only one case of delayed gastric empting, for which medication was required, in the TLuRYGJ group. The endoscopic findings of the remnant stomach for bile reflux gastritis at six months after surgery were better in the TLuRYGJ group than in the TLB-I group. CONCLUSION: A TLuRYGJ was found to be effective in preventing bile reflux gastritis and the Roux stasis syndrome.
Bile Reflux ; Classification ; Gastrectomy* ; Gastric Bypass* ; Gastric Stump ; Gastritis ; Gastroenterostomy* ; Humans ; Laparoscopy ; Medical Records ; Postgastrectomy Syndromes

BACKGROUND/AIMS: Reflux gastritis after gastrectomy is believed to be due to reflux of bile into residual stomach. However the substances that cause gastritis have not yet been precisely defined. Helicobacter pylori (H. pylori) infection is considered one of the most important pathogenetic factors in gastritis. The prevalence of H. pylori infection and the role of its infection on reflux gastritis after gastrectomy were investigated. METHODS: Eighty-one patients who had undergone subtotal gastrectomy were enrolled. Rapid urease test and histologic examination for H. pylori infection were performed during gastrofiberscopy. An eradication of H. pylori was attempted in fifteen H. pylori-positive patients who suffered from gastritis symptoms after gastrectomy. Follow-up endoscopy was performed more than 4 weeks after the end of eradication treatment. RESULTS: Forty-nine patients (60.5%) demonstrated H. pylori infection in their residual stomach. The histological gastritis score in patients with H. pylori infection was significantly higher than that without infection. Ten of the 15 patients (66.7%) with H. pylori infection had their infection successfully eradicated. And also their symptoms and histological gastritis score were significantly improved. CONCLUSIONS: H. pylori infection does play an important role on reflux gastritis after subtotal gastrectomy.
Bile ; Endoscopy ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump ; Gastritis* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Prevalence ; Urease

We herein describe a case of cystic lymphangioma in the greater omentum of the remnant stomach, which is thought it to be related with subtotal gastrectomy 10 yr ago for early gastric cancer. A 76-yr-old man was admitted to our department with postprandial abdominal discomfort and bowel habit change. Intraabdominal multilocular cystic mass was detected by ultrasonography and computed tomography. We performed a complete En-bloc tumor resection including spleen and distal pancreas, and histological examination confirmed cystic lymphangioma originated from the greater omentum of the remnant stomach. Although the etiology of omental lymphangioma remains largely unclear, these findings suggested strongly that obstruction of the lymphatic vessels after gastric resection for gastric carcinoma might be the most plausible cause. The surgical extirpation with resection of organs involved appears to be a treatment of choice for such unusual case.
Aged ; *Gastrectomy ; Gastric Stump/*pathology ; Humans ; Lymphangioma, Cystic/*pathology ; Male ; Omentum/*pathology ; Stomach Neoplasms/surgery