Systemic Administration of Steroid Successful in Treatment of Edematous Anastomotic Stenosis following Delta-shaped Anastomosis —A Report of a Case—

Abstract

A 76-year-old man underwent laparoscopic distal gastrectomy for gastric cancer which was detected by a medical checkup. We performed Billroth I reconstruction using delta-shaped anastomosis. Since his postoperative meal intake was favorably restored, he was discharged on the 8^th postoperative day. On the 22^nd postoperative day, he presented with upper abdominal distention and an abdominal CT scan revealed significant expansion of the gastric remnant. Following an upper gastrointestinal endoscopy taken after decompression, he was diagnosed with edematous stenosis at the anastomosis. After systemic administration of steroid was started, his symptom has improved rapidly, and he could restore oral intake from the 5^th day after initiation of the steroid therapy. Thereafter the dose of the steroid was gradually decreased, and the steroid therapy was terminated after a total of 38-day administration. No recurrence of stenotic symptoms has occurred, as of 9 months after the operation. It is considered that systemic steroid therapy for edematous stenosis after delta-shaped anastomosis is minimally invasive and useful.