Abstract
An 80-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the upper to middle gastric body. The tumor was completely resected, however, endoscopy showed a gastric perforation in the ulcer bed during ESD, and endoscopic closure by metal clips was performed. After ESD, the patient developed peritonitis and emergency exploratory laparoscopy was performed. Laparoscopic examination revealed the perforation in the gastric body because of dropout of clips. The stomach perforation was repaired laparoscopically with primary sutures. Perforated site was covered by omentum and the abdomen and pelvis were irrigated. The patient did well postoperatively and recovered without complications. Laparoscopic repair and drainage may be appropriate procedure for gastric perforation uncontrolled by endoscopic repair after ESD for EGC, because it is safe and minimally invasive.
