Abstract
We report a case of anastomotic leakage after total gastrectomy treated by endoscopic clipping. The subject was a 63-year-old man with a hiatus hernia. In October 2010, he underwent laparoscopy-assisted total gastrectomy for early gastric cancer. The anastomosis was performed using a circular stapler (OrVilTM). A high fever of 38.5°C occurred on postoperative day 2 and a routine gastrografin meal examination revealed anastomotic leakage of esophagojejunostomy. Gastrografin leaked into the mediastinum. We completely closed the fistula of anastomosis using 3 large-sized clips endoscopically at once. The mediastinal abscess drainage was performed under CT guidance. Meal intake started on postoperative day 20, and the patient was discharged on postoperative day 33. There have been few reports on the treatment for anastomotic leakage by endoscopic clipping, however, we speculate this procedure to be effective for esophagojejunal anastomotic leakage.
