Early Postoperative Endoscopy in the Operated Stomach

Abstract

Early endoscopy in the upper alimentary tract after surgical operations on the stomach reveals multifarious diagnostic and therapeutic possibilities to give decisive help to patients when applied critically and rationally. The possibilities of endoscopy can differentiate between active and arrested bleeding episodes, can induce hemostasis, can diagnose and overcome sutureline insufficiencies, can differentiate the different kinds of stenosis in the lower esophageal junction. It can treat postoperative atony, diagnose perforation at an earlier stage, localize obstructive jaundice, remove intestinal foreign bodies and characterize unexpected postoperative histological findings.

Endoscopic examination of the operated stomach: A review and a systematic approach

“…5 Post-endoscopic care follows the rules of general esophagogastroduodenoscopy. 5 If there are confusing endoscopic appearances, and to avoid possible observer error, repeated or second-opinion endoscopy may be invaluable. 3…”

“…5 '24 Endoscopy can also help in the treatment of postoperative atony. 24 If mechanical obstruction of a recent anastomosis is suspected, it is the task of the endoscopist to evaluate the size and location of the stoma, to investigate severe inflammation and edema, and to look for suture material compromising the lumen. 13 Inspection of the duodenal stump must be avoided in the freshly operated patient.…”

Drainage-tube penetration into the gastric lumen, mimicking a high-volume enterocutaneous fistula

“…Although sporadic reports have been published [3,4] regarding its use in the early postoperative period, many surgeons do not perform endoscopy at this time for safety reasons. However, clinical and experimental data [1,5] now suggest that endoscopy can be performed safely during the immediate postoperative period when indicated.…”