Two Cases of Laparoscopic Adhesiolysis for Chronic Abdominal Pain without Intestinal Obstruction after Total Gastrectomy
A 57-year-old male underwent distal gastrectomy with gastrojejunostomy under the diagnosis of gastric cancer in May, 2007. Recurrence in the remnant stomach was detected during a regular check-up, and completion gastrectomy was performed in March, 2010. However, the patient complained of intermittent chronic abdominal pain radiating from his back to his waist for one year following the completion gastrectomy. We performed abdominopelvic CT, an upper gastrointestinal series, small bowel series, and simple x-rays, none of which indicated stricture, intestinal obstruction, or strangulation (). The pain was refractory to medical treatment.\nWe performed diagnostic laparoscopy in June, 2012, and the surgical technique was the same as in case 1. The operative findings included an adhesion in the jejunojejunostomy anastomosis and dense adhesion in the small bowel itself. But there was no delay or disturbance of passage through jejunojejunostomy. The operation time was 100 minutes and he was discharged from the hospital on postoperative day 1 without any complications. He is doing well, although he has reported intermittent abdominal pain and has stopped taking analgesics. Two months thereafter, he has no abdominal pain and is doing well.