J Gastric Cancer.  2010 Jun;10(2):75-78.

Totally Laparoscopic Distal Gastrectomy with ROUX-EN-Y Reconstruction for Treatment of Duodenal Ulcer Obstruction

• Kim MG
• Kim BS
• Kim TH
• Kim KC
• Yook JH
• Oh ST
• Kim BS

Abstract

Because of advancement of medical treatment, surgical management of gastric or duodenal ulcer was indicated for treatment of perforation, massive hemorrhage and obstruction. The distal gastrectomy including ulcer was known as principle method of duodenal ulcer obstruction, but actually many surgeons have performed only bypass surgery for the difficulty of formation of duodenal stump. In our case, 61-year-old male with repetitive duodenal ulcer obstruction transferred with obstruction due to deformities and inflammations of duodenal ulcer. We had performed totally laparoscopic distal gastrectomy with ROUX-EN-Y reconstruction using the clear visibility of laparoscopy and fine dissections of harmonic scalpel. The patient started soft diet on postoperative day 5 and discharged on postoperative day 8. He returned to work after discharging immediately.

Keyword

Totally laparoscopic gastrectomy; Duodenal ulcer obstruction

MeSH Terms

Congenital Abnormalities
Diet
Duodenal Ulcer
Gastrectomy
Hemorrhage
Humans
Inflammation
Laparoscopy
Male
Middle Aged
Ulcer

Figure

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  Fig. 1 Endoscopic findings of deformed duodenal bulb and gastric outlet obstruction.

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  Fig. 2 CT findings of deformed duodenal bulb and distended stomach.

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  Fig. 3 (A) Edematous stomach is accompanied by gastric outlet obstruction. (B) After the dissection of posterior of duodenal bulb. (C) Duodenal stump. (D) State of gastrojejunostomy using the endoscopic linear staplers.

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  Fig. 4 Postoperative UGI finding.

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