-Case Reports-

Endoscopic Detorsion for Early Postoperative Roux Limb Torsion after Laparoscopic Gastrectomy: A Case Report and Literature Review

Nobuyuki Sakurazawa¹, Hiroki Arai¹, Tomohiko Yasuda¹, Komei Kuge¹, Shou Kuriyama², Hideyuki Suzuki¹ and Hiroshi Yoshida²

¹Department of Surgery and Digestive Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
²Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan

Various types of obstruction can occur after a gastrectomy for gastric cancer. If proper treatment is not performed, such obstructions can lead to serious conditions. Early postoperative Roux limb torsion is a rare complication, and few reports of endoscopic treatment for this complication have been made. In the present report, we describe the endoscopic detorsion of Roux limb torsion in two patients. The first case was a 77-year-old woman who underwent a laparoscopic distal gastrectomy with Roux-en-Y (R-Y) reconstruction for early gastric cancer and a laparoscopic ileocecal resection (ICR) for early colorectal cancer. On the 12^th day after the gastrectomy, a Roux limb torsion was observed. Endoscopic detorsion was performed, and the patient recovered. She was discharged on postoperative day 40. The second case was a 73-year-old man who underwent a laparoscopic-assisted total gastrectomy with a R-Y reconstruction for early gastric cancer. On the 8^th day after the gastrectomy, a Roux limb torsion occurred at the Y-shaped anastomosis (Y-anastomosis). Endoscopic detorsion was performed, and the patient recovered. He was discharged on postoperative day 17. In summary, we experienced two cases in which an endoscopic reduction of a Roux limb torsion was performed at the Y-anastomosis after gastrectomy with R-Y reconstruction. This study presents a further review of these cases and a summary of the existing literature.

J Nippon Med Sch 2021; 88: 544-550

Keywords
gastric cancer, Roux-en-Y, Roux limb, torsion, endoscopic detorsion

Correspondence to
Nobuyuki Sakurazawa, Department of Surgery and Digestive Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
nsakuraz@nms.ac.jp

Received, July 1, 2020
Accepted, October 28, 2020