Postoperative anastomotic hemorrhage after gastrectomy

BACKGROUND: Postoperative anastomotic hemorrhage is a relatively rare complication. However, when it does occur, immediate treatment is needed. METHODS: In all, 1,700 patients underwent curative gastrectomy between 2000 and 2010. Anastomotic hemorrhage was observed in 9 patients after surgery. The clinical course of these 9 patients was analyzed. RESULTS: The median age of the patients was 62 years, and all patients were men. Two patients underwent distal gastrectomy, 1 underwent laparoscopic distal gastrectomy, and 6 underwent total gastrectomy. Bleeding occurred as follows: 5 were at gastro- or esophagojejunostomic site, 2 were at gastroduodenostomic site, and 2 were at jejunojejunostomic site. Five patients received conservative treatment and 2 underwent re-operation. Two additional patients achieved complete hemostasis with endoscopic treatment. The patients who received endoscopic treatment were discharged earlier than those who received other treatments. CONCLUSIONS: Endoscopic intervention was useful for the diagnosis and treatment of postoperative anastomotic hemorrhage.