Abstract
A stricture formation resulting in impedance of gastric emptying is a fairly common complication after gastric surgery with endoscopy being the most direct way of diagnosis. When this and other methods fail in detecting the complication, the proper diagnosis can become challenging. We present an unusual case of an acquired gastric stricture after the gastrointestinal stromal tumor (GIST) resection. A stapled strictureplasty was completed with the simultaneous application of the diagnostic laparoscopy and the intra-operative EGD. We perform the comprehensive literature review (Pubmed-Cochrane 1990-current) diagnostic and surgical treatments of post resection gastric strictures.
Highlights
The patient is a 66-year-old female with complaints of chronic abdominal epigastric pain and early satiety
A 3-cm supra-umbilical incision was made with the scalpel at the site of the previous incision and its scar. This site was previously used at the time of gastrointestinal stromal tumor (GIST) tumor resection for the initial diagnostic laparoscopy
We undertook very extensive lysis of adhesions using endoscopic scissors or the harmonic scalpel as appropriate, removing adhesions between the stomach and the liver, and the stomach and the abdominal wall. It looked like the duodenum which was adhered all the way to the lateral abdominal wall likely causing angulation at that point which could possibly be the reason of patient’s symptoms; the adhesions of the duodenum to the lateral abdominal wall were released
Summary
The patient is a 66-year-old female with complaints of chronic abdominal epigastric pain and early satiety. The decision was made to perform a diagnostic laparoscopy along with intra-operative EGD repairing the umbilical hernia afterwards as its site was intended to be used for one of the port sites. A 3-cm supra-umbilical incision was made with the scalpel at the site of the previous incision and its scar This site was previously used at the time of GIST tumor resection for the initial diagnostic laparoscopy. We undertook very extensive lysis of adhesions using endoscopic scissors or the harmonic scalpel as appropriate, removing adhesions between the stomach and the liver (see Figure 1), and the stomach and the abdominal wall. The patient’s diet was advanced and she was discharged home on postoperative day number 3
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