title: One-stage laparoscopic-assisted resection of gastrojejunocolic fistula after gastrojejunostomy for duodenal ulcer: a case report.
abstract: BACKGROUND
  Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It was thought to be a late complication related to stomal ulcers as a result of inadequate gastrectomy or incomplete vagotomy. We report a case of gastrojejunocolic fistula after gastrojejunostomy for peptic ulcer treated with one-stage laparoscopic resection.
  
  
  METHODS
  A 41-year-old Japanese man complained of diarrhea for 10 months, as well as severe weight loss and weakness. After admission, we immediately started intravenous hyperalimentation. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient's nutritional status had improved, one-stage surgical intervention was performed laparoscopically. After the operation, our patient recovered uneventfully and his body weight increased by 5 kg within three months.
  
  
  CONCLUSIONS
  Modern management of gastrojejunocolic fistula is a one-stage resection because of the possibility of early recovery from malnutrition using parenteral nutritional methods. Today, laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures. We describe the first case of gastrojejunocolic fistula treated laparoscopically by one-stage resection and review the literature.
authors: Department of Surgery, Goshi Hospital 1-8-20, Nagasu-Nishi Dori, Amagasaki City, Hyogo, 660-0807, Japan. mtake@hyo-med.ac.jp.
authors: Masashi
authors: M
authors: Takemura
authors: Genya
authors: G
authors: Hamano
authors: Takayoshi
authors: T
authors: Nishioka
authors: Mamiko
authors: M
authors: Takii
authors: Katsuyuki
authors: K
authors: Mayumi
authors: Takashi
authors: T
authors: Ikebe