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Complications after total gastrectomy and esophagojejunostomy: radiologic evaluation
M S Levine1, A R Fisher, S E Rubesin
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
AJR. American Journal of Roentgenology
|December 1, 1991
Summary
Total gastrectomy with esophagojejunostomy can lead to complications like anastomotic leaks and strictures. Radiologists must recognize these findings to ensure proper patient care after this surgery.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Oncology
Background:
- Total gastrectomy followed by esophagojejunostomy is a frequently performed surgical procedure.
- This surgery is associated with various early and late postoperative complications.
Purpose of the Study:
- To review the radiologic findings of complications following total gastrectomy and esophagojejunostomy.
- To familiarize radiologists with normal and abnormal postoperative imaging.
Main Methods:
- Retrospective review of 26 patients who underwent total gastrectomy and esophagojejunostomy between 1980 and 1990.
- Postoperative upper gastrointestinal studies using water-soluble contrast or barium were analyzed.
Main Results:
- 19% of patients experienced anastomotic leaks.
- 19% had transient anastomotic narrowing in the early postoperative period, and 23% had late narrowing due to strictures or tumor recurrence.
- Alkaline reflux esophagitis was noted in 43% of loop esophagojejunostomy patients, with distal esophageal strictures in 11% of Roux-en-Y cases.
Conclusions:
- Radiologists must be aware of the spectrum of complications after total gastrectomy and esophagojejunostomy.
- Familiarity with imaging findings aids in timely diagnosis and management of postoperative issues.
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