Park Dong Jin, Kim Byung Gyu, Jeong In Du, Kim Gyu Yeol
Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Ann Surg Treat Res. 2018 Mar;94(3):159-161. doi: 10.4174/astr.2018.94.3.159. Epub 2018 Feb 28.
A 58-year-old man underwent laparoscopy-assisted distal gastrectomy (LADG) with Billroth I gastroduodenostomy due to early gastric cancer. During surgery, the perigastric vessels were ligated with Hem-o-Lok clips. Esophagogastroduodenoscopy (EGD) 6 months later showed a fungating mass at the anastomosis site. Repeat EGD 1 year after LADG showed a Hem-o-Lok clip at the fungating mass lesion. Because the patient was asymptomatic, with no major abnormalities on clinical examination, and endoscopic removal of the clip would have been difficult due to the presence of adhesions and inflammation, no attempt was made to remove the clip. The patient remained well after the exposed Hem-o-Lok clip was identified. A third EGD 6 months later showed that the clip had disappeared from the anastomosis site, and that this site was covered with normal mucosa surrounding the scar.
一名58岁男性因早期胃癌接受了腹腔镜辅助远端胃切除术（LADG），并进行了毕罗I式胃十二指肠吻合术。手术过程中，胃周血管用Hem-o-Lok夹结扎。6个月后的食管胃十二指肠镜检查（EGD）显示吻合口处有一个蕈状肿物。LADG术后1年复查EGD，在蕈状肿物病变处可见一个Hem-o-Lok夹。由于患者无症状，临床检查无重大异常，且因存在粘连和炎症，内镜下取出夹子困难，故未尝试取出夹子。在发现暴露的Hem-o-Lok夹后，患者情况良好。6个月后的第三次EGD显示，夹子已从吻合口处消失，该部位被瘢痕周围的正常黏膜覆盖。
