Four Cases of Perforated Gastric Cancer Treated with Primary Laparoscopic Closure Followed by Gastrectomy

Abstract

The strategy for perforated gastric cancer is still controversial. In our institution, we primarily perform laparoscopic omental plugging or patching and drainage for the perforation, and secondly perform a gastrectomy. Between 2013 and 2017, we experienced four cases of perforated gastric cancer treated with primary laparoscopic closure followed by a gastrectomy. They included two males and two females. The age ranged from 69～76 (median 74) years. Preoperative diagnosis was gastric carcinoma (confirmed by pathological findings) in two, and suspected gastric carcinoma based on CT findings in two. All patients were treated laparoscopically at first （omental plugging for two, and omental patching for two）. Then, the second operation was performed with a laparotomy (distal gastrectomy for three, total gastrectomy for one). No major procedure–complication was encountered. Two patients died of gastric cancer after 13 and 11 months after the first operation and two patients were alive for 39 and 16 months. The strategy for perforated gastric cancer consisting of primary laparoscopic closure followed by the second gastrectomy was thought to be feasible.