Y脚吻合部狭窄を合併した超高齢者胃全摘の一例

An 88-year-old male patient was referred to our hospital after being diagnosed with gastric cancer during extensive investigations for anemia. The patient underwent total gastrectomy followed by Roux-en Y reconstruction. An esophagus jejunum anastomosis was performed using a Curbed-Shaft Detachable Head Circular Stapler （25 mm）（CDH25）. An anastomosis of the jejunum was performed approximately 40 cm distal to the esophagus jejunum anastomosis using a Straight Shaft Detachable Head Circular Stapler（21 mm）（SDH21）. A seromuscular suture was applied to each anastomotic site. The patient started oral intake on Day 8 after the operation, and was transferred to the urology department on Day 22 for the treatment of renal cancer. Approximately 2 weeks after the transfer, the patient developed fever above 38℃. CT revealed marked enlargement of the duodenum, suggesting stenosis at the Y anastomotic site. The stenosis was successfully treated by endoscopic balloon dilatation without performing. Here, we report a case with favorable outcome.