Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site

Abstract Background Palliative endoscopic stent placement may be considered in patients with malignant gastrointestinal obstruction. Stent migration is a potential complication, particularly for those placed at a surgical anastomosis or across a stricture caused by extra-alimentary tract factors. We...

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Main Authors: Kiwa Son, Koji Shindo, Kenoki Ouchida, Taiki Moriyama, Koji Tamura, Kinuko Nagayoshi, Yusuke Mizuuchi, Naoki Ikenaga, Kohei Nakata, Masafumi Nakamura
Format: Article
Language:English
Published: SpringerOpen 2023-06-01
Series:Surgical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s40792-023-01699-4
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author Kiwa Son
Koji Shindo
Kenoki Ouchida
Taiki Moriyama
Koji Tamura
Kinuko Nagayoshi
Yusuke Mizuuchi
Naoki Ikenaga
Kohei Nakata
Masafumi Nakamura
author_facet Kiwa Son
Koji Shindo
Kenoki Ouchida
Taiki Moriyama
Koji Tamura
Kinuko Nagayoshi
Yusuke Mizuuchi
Naoki Ikenaga
Kohei Nakata
Masafumi Nakamura
author_sort Kiwa Son
collection DOAJ
description Abstract Background Palliative endoscopic stent placement may be considered in patients with malignant gastrointestinal obstruction. Stent migration is a potential complication, particularly for those placed at a surgical anastomosis or across a stricture caused by extra-alimentary tract factors. We report a patient with left renal pelvis cancer and gastrojejunostomy obstruction who underwent endoscopic stent placement and laparoscopic stent fixation. Case presentation A 60-year-old male with peritoneal dissemination of a left renal pelvis cancer was admitted for treatment of upper gastrointestinal obstruction. A laparoscopic gastrojejunostomy had been previously performed for cancer invasion of the duodenum. Imaging showed gastroduodenal dilation and impaired passage of contrast medium through the efferent loop of the gastrojejunostomy. Gastrojejunostomy anastomosis site obstruction due to dissemination of left renal pelvis cancer was diagnosed. Conservative treatment failed and endoscopic stent placement with laparoscopic stent fixation was performed. After surgery, the patient was able to tolerate oral intake and he was discharged without complications. The patient gained weight and was able to resume chemotherapy, indicating the procedure was effective. Conclusions Endoscopic stent placement with laparoscopic stent fixation for malignant upper gastrointestinal obstruction appears effective in patients with a high risk of stent migration.
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spelling doaj.art-b6f7499620de4e0aba0fc6dc4b65bf982023-07-02T11:25:27ZengSpringerOpenSurgical Case Reports2198-77932023-06-01911610.1186/s40792-023-01699-4Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis siteKiwa Son0Koji Shindo1Kenoki Ouchida2Taiki Moriyama3Koji Tamura4Kinuko Nagayoshi5Yusuke Mizuuchi6Naoki Ikenaga7Kohei Nakata8Masafumi Nakamura9Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityAbstract Background Palliative endoscopic stent placement may be considered in patients with malignant gastrointestinal obstruction. Stent migration is a potential complication, particularly for those placed at a surgical anastomosis or across a stricture caused by extra-alimentary tract factors. We report a patient with left renal pelvis cancer and gastrojejunostomy obstruction who underwent endoscopic stent placement and laparoscopic stent fixation. Case presentation A 60-year-old male with peritoneal dissemination of a left renal pelvis cancer was admitted for treatment of upper gastrointestinal obstruction. A laparoscopic gastrojejunostomy had been previously performed for cancer invasion of the duodenum. Imaging showed gastroduodenal dilation and impaired passage of contrast medium through the efferent loop of the gastrojejunostomy. Gastrojejunostomy anastomosis site obstruction due to dissemination of left renal pelvis cancer was diagnosed. Conservative treatment failed and endoscopic stent placement with laparoscopic stent fixation was performed. After surgery, the patient was able to tolerate oral intake and he was discharged without complications. The patient gained weight and was able to resume chemotherapy, indicating the procedure was effective. Conclusions Endoscopic stent placement with laparoscopic stent fixation for malignant upper gastrointestinal obstruction appears effective in patients with a high risk of stent migration.https://doi.org/10.1186/s40792-023-01699-4Laparoscopic stent fixationStent migrationAnastomosis site obstructionGastrojejunostomyExternal alimentary tract compressionRecurrent malignancy
spellingShingle Kiwa Son
Koji Shindo
Kenoki Ouchida
Taiki Moriyama
Koji Tamura
Kinuko Nagayoshi
Yusuke Mizuuchi
Naoki Ikenaga
Kohei Nakata
Masafumi Nakamura
Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
Surgical Case Reports
Laparoscopic stent fixation
Stent migration
Anastomosis site obstruction
Gastrojejunostomy
External alimentary tract compression
Recurrent malignancy
title Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
title_full Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
title_fullStr Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
title_full_unstemmed Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
title_short Endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
title_sort endoscopic stent placement with laparoscopic stent fixation in a patient with obstruction at a gastrojejunostomy anastomosis site
topic Laparoscopic stent fixation
Stent migration
Anastomosis site obstruction
Gastrojejunostomy
External alimentary tract compression
Recurrent malignancy
url https://doi.org/10.1186/s40792-023-01699-4
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