Lim Jeong Hyeon, Kwon Lyo Min, Kim Min-Jeong, Park Jung Ho
J Korean Soc Radiol. 2024 Nov;85(6):1183-1188. doi: 10.3348/jksr.2024.0053. Epub 2024 Oct 26.
Total gastrectomy with Roux-en-Y esophagojejunostomy is a common surgical treatment for early gastric cancer; however, postoperative complications such as anastomotic leaks remain a serious risk. This report details a 59-year-old female who underwent total gastrectomy with Roux-en-Y esophagojejunostomy for early gastric cancer, followed by percutaneous embolization for esophagojejunal (EJ) anastomotic leakage. Despite initial percutaneous drainage for fluid accumulation at the EJ site, subsequent CT revealed significant anastomotic dehiscence. Endoscopic treatment was ineffective and surgical intervention posed a high risk of mortality; therefore, percutaneous embolization was requested. This involved four sessions using cut gel foam, N-butyl-2-cyanoacrylate, and lipiodol. The procedure was successful without complications and led to complete resolution of the leakage and dehiscence. Follow-up CT scans at 6- and 32-months post-procedure confirmed the absence of recurrence. This case highlights the potential of percutaneous embolization as a treatment option for anastomotic leakage after Roux-en-Y esophagojejunostomy.
全胃切除术加 Roux-en-Y 食管空肠吻合术是早期胃癌的常见手术治疗方法；然而，术后并发症如吻合口漏仍然是一个严重风险。本报告详细介绍了一名 59 岁女性，她因早期胃癌接受了全胃切除术加 Roux-en-Y 食管空肠吻合术，随后因食管空肠（EJ）吻合口漏接受了经皮栓塞治疗。尽管最初对 EJ 部位的积液进行了经皮引流，但随后的 CT 显示吻合口有明显裂开。内镜治疗无效，手术干预有很高的死亡风险；因此，请求进行经皮栓塞治疗。该治疗使用切割明胶海绵、N-丁基-2-氰基丙烯酸酯和碘油进行了四次治疗。该手术成功且无并发症，导致漏液和裂开完全消退。术后 6 个月和 32 个月的随访 CT 扫描证实无复发。该病例突出了经皮栓塞作为 Roux-en-Y 食管空肠吻合术后吻合口漏治疗选择的潜力。
