Laparoscopic Approach for Esophagojejunal Anastomotic Leak in Patients Requiring Re-Look Intervention: How We Do It

Background: Esophagojejunal anastomotic leak (EJAL) is a serious and often life-threatening complication following total gastrectomy. There no standard management strategy, the optimal approach remains controversial. Whilst non-operative (with or without percutaneous drainage), endoscopic (stents, clips, vacuum devices) preferred initial management, there subset of EJAL patients that require operative intervention because uncontrolled with sepsis potential high mortality. Methods: We present early clinical results minimally invasive novel surgical technique (continuous suction isoperistaltic jejuno-esophagostomy tube, SIJET) to divert saliva enteric secretions away from area thus creating hypothesised concept “no leak” scenario. The details this are described illustrated. Results: This first report laparoscopic for insertion SIJET in two esophagojejunal leaks managed successfully. Both had failed progress on sepsis. Conclusion: absolute prerequisite complete healing an adequate drainage undrained fluid collections diversion luminal defect. Laparoscopic provides option gastrectomy