Endoscopic treatment of gastric perforation, bilio-digestive anastomosis dehiscence and jejunal stump leak after radical pancreatectomy

Abstract Text A 63-years-old man underwent duodenopancreatectomy for an adenocarcinoma of the Ampulla of Vater. Ten days after the procedure, since pancreaticojejunal anastomosis leak was documented, the patient underwent radical pancreatectomy. A few days after, the patient presented ischemic gastric perforation, biliodigestive anastomosis and jejunal stamp leaks, so endoscopic exam was performed. After peritoneal necrosectomy, multiple enteral and colonic fc-SEMS were placed to connect the two cavities and to exclude the necrotic collection and a biliary fc-SEMS was placed. Fifty-four days after, a fibrotic tunnel connecting gastric cavity and jejunal stamp was documented and no extraluminal passage of contrast medium was observed.