title: Laparoscopic lysis for jejunostomy-related ileus following laparoscopy-assisted total gastrectomy: a case report.
abstract: A 54-year-old man was admitted to our hospital with severe nausea, vomiting and abdominal pain. He had had laparoscopy-assisted total gastrectomy with Roux-en-Y reconstruction and tube jejunostomy for gastric cancer 2 years earlier. Abdominal CT revealed that the duodenum and upper jejunum were markedly dilated and that the dilated jejunum had collapsed at the jejunostomy site. Emergency laparoscopic surgery with three ports was performed for jejunostomy-related ileus. Abdominal adhesion was very small, and the Roux-en-Y limb was rotated counterclockwise at the jejunostomy site. A magnified laparoscopic view showed that the site of peritoneopexy was the axis of rotation. After the axis was dissected with a Harmonic scalpel, the rotation was released immediately. The patient's postoperative course was uneventful and he was discharged 4 days after the operation. Because the axis of rotation was identified easily by laparoscope, laparoscopic surgery was a safe and useful technique for a patient with jejunostomy-related ileus.
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Inoue
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Etsushi
authors.initials: E
authors.lastname: Ogawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Horikawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Inaba
authors.forename: Ryoji
authors.initials: R
authors.lastname: Fukushima
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D045823:Ileus / Q000209:etiology* / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D007582:Jejunostomy / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000267:Tissue Adhesions / Q000601:surgery
keywords: Ileus; laparoscopy-assisted total gastrectomy; tube jejunostomy