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Laparoscopic stomach‐partitioning gastrojejunostomy in preparation for distal gastrectomy and Billroth‐II reconstruction after neoadjuvant chemotherapy for advanced gastric cancer with gastric outlet obstruction: A case report
Author(s) -
Ishida Hiroyuki,
Cho Haruhiko,
Tsuchida Kazuhito,
Onoyama Haruna,
Maezawa Yukio
Publication year - 2020
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12741
Subject(s) - medicine , gastrectomy , gastric outlet obstruction , billroth ii , billroth i , cancer , stomach , surgery , metastasis , gastroenterology
Abstract Gastrojejunostomy has been performed as a palliative treatment for unresectable, advanced gastric cancer patients with gastric outlet obstruction (GOO). However, its role before neoadjuvant chemotherapy (NAC) has not been established. We present the case of a 72‐year‐old man with distal advanced gastric cancer with GOO. Computed tomography showed para‐aortic lymph node (PAN) metastasis without other distal metastasis. We performed laparoscopic stomach‐partitioning gastrojejunostomy (LSPGJ), which avoided new gastrojejunostomy reconstruction when performing distal gastrectomy after NAC. His oral intake improved after surgery and NAC was successfully administered on postoperative day 14, without surgical complications. After completion of NAC, the patient underwent radical distal gastrectomy with gastrojejunostomy reused as Billroth‐II reconstruction. A histological examination revealed no residual cancer cells. LSPGJ, with partitioning on the expected resection line in distal gastrectomy after NAC, can be useful for treating advanced gastric cancer with GOO when NAC followed by curative gastrectomy is planned.