Successful Systemic Steroid Administration for the Treatment of Edematous Anastomotic Stenosis After the Laparoscopic Augmented Rectangle Technique for Billroth I Reconstruction for Laparoscopic Distal Gastrectomy

Abstract

Edematous anastomotic stenosis is a well-known complication following Billroth I anastomosis for distal gastrectomy. Currently, there is no established treatment for this condition. A 54-year-old female patient underwent the augmented rectangle technique for Billroth I reconstruction after total laparoscopic distal gastrectomy for early gastric cancer. On postoperative day (POD) 9, the patient started vomiting. During the conservative waiting period, edematous anastomotic stenosis was diagnosed using imaging on PODs 11 and 13. Systemic steroid administration was initiated on POD 13, and the drainage volume of the nasogastric tube decreased four days after initiation. The edematous anastomosis stenosis improved, and gastrografin flowed into the duodenum on POD 19. Food intake was started on POD 20. Oral steroid administration was continued after hospital discharge and gradually terminated. Systemic steroid treatment may help improve edematous anastomotic stenosis.