Surgery Today

, Volume 49, Issue 3, pp 187–196 | Cite as

Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer

  • Rie Makuuchi
  • Tomoyuki Irino
  • Yutaka Tanizawa
  • Etsuro Bando
  • Taiichi Kawamura
  • Masanori TerashimaEmail author
Review Article


Esophagojejunal anastomotic leakage (EJAL) is a serious complication of total or proximal gastrectomy for gastric cancer, with a reported incidence of 2.1–14.6% and mortality of up to 50%. EJAL is an independent prognostic factor for the poor survival of gastric cancer patients. Meticulous surgical techniques, experience with anastomotic devices, and a thorough understanding of various risk factors and preventive measures are essential and early diagnosis is critical for preventing EJAL-related death. Patients with suspected EJAL must be evaluated promptly, but contrast swallow is not recommended. There is no standard treatment strategy for EJAL, although conservative treatment with drainage and nutritional support is the most common approach. Effective endoscopic treatments have been reported but need further validation. Surgical treatment is associated with high mortality but should be considered to prevent death from suboptimal EJAL management, for patients with severe sepsis or when conservative treatment has failed.


Gastric cancer Anastomotic leakage Esophagojejunostomy Postoperative complication Review 


Compliance with ethical standards

Conflict of interest

Rie Makuuchi and the co-authors have no conflicts of interest to declare.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Rie Makuuchi
    • 1
  • Tomoyuki Irino
    • 1
  • Yutaka Tanizawa
    • 1
  • Etsuro Bando
    • 1
  • Taiichi Kawamura
    • 1
  • Masanori Terashima
    • 1
    Email author
  1. 1.Division of Gastric SurgeryShizuoka Cancer CenterShizuokaJapan

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