Successful Fistula Closure Using an Over-the-Scope Clip for Early-Onset Gastrojejunocolic Fistula after Gastric Cancer Surgery

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  • Over-the-scope clipによる瘻孔閉鎖が奏効した胃癌術後早期発症胃空腸結腸瘻の1例

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Abstract

<p>There have been several recent reports of successful use of an over-the-scope clip (OTSC) for postoperative anastomosis leakage in the gastrointestinal tract. We experienced a case of gastrojejunocolic fistula, a rare postoperative complication of gastric cancer, in which the fistula was successfully closed using an OTSC. A 68-year-old man underwent distal gastrectomy for gastric cancer with pyloric stenosis. Disseminated nodules were observed and the histopathological diagnosis was stage IV poorly differentiated adenocarcinoma. On postoperative day (POD) 7, antibiotic administration was started with nasogastric tube insertion because anastomosis leakage was suspected. On POD 14, drainage in the nasogastric tube became stool juice-like and gastrojejunocolic fistula was diagnosed in a gastrografin X-ray study. Fistula closure with an OTSC was performed on POD 16. After the OTSC procedure, the fistula was almost closed and oral intake became possible. The patient was discharged 18 days after the procedure. Thus, in this case, closure of a gastrojejunocolic fistula using an OTSC was useful for reduction of physical and mental burdens on the patient without impairment of QOL.</p>

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