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Updated: Jan 18, 2026

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
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[A Case of Laparoscopic Completion Gastrectomy for Pouch Dysfunction after Proximal Gastrectomy].

Motohiro Chuman1, Ryo Ohta, Toshimasa Fujio

  • 1Dept. of Surgery, Kitasato University Medical Center.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
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Summary

This case study details a laparoscopic completion gastrectomy to treat severe jejunal pouch dysfunction following gastric cancer surgery. The procedure successfully resolved malnutrition and improved reflux esophagitis in a long-term survivor.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Digestive Surgery

Background:

  • Proximal gastrectomy with jejunal pouch interposition is a surgical option for gastric cancer.
  • Jejunal pouch dysfunction can lead to severe complications like malnutrition and reflux esophagitis.
  • Long-term survivors of gastrectomy require monitoring for delayed complications.

Purpose of the Study:

  • To report the first case of laparoscopic completion gastrectomy for jejunal pouch dysfunction.
  • To describe the management of severe malnutrition and reflux esophagitis secondary to pouch dysfunction.
  • To highlight the importance of considering jejunal pouch dysfunction in long-term gastrectomy survivors.

Main Methods:

  • A laparoscopic completion gastrectomy and jejunal pouch resection were performed.
  • Roux-en-Y reconstruction with jejuno-jejunal anastomosis was utilized.
  • Preoperative nutritional support via laparoscopic enterostomy was administered for 6 months.

Main Results:

  • The patient experienced significant improvement in nutritional status (BMI increased from 13.2 to 19.7).
  • Reflux esophagitis (LA grade D) improved to grade M post-surgery.
  • The patient was discharged with oral intake and showed sustained recovery at 5-year follow-up.

Conclusions:

  • Laparoscopic completion gastrectomy is a viable option for managing severe jejunal pouch dysfunction.
  • Early recognition and intervention are crucial for improving outcomes in patients with post-gastrectomy complications.
  • Jejunal pouch dysfunction should be considered in the long-term management of gastric cancer survivors.