Chemotherapy Related Late Enterocutaneous Fistula Following Laparoscopic Total Gastrectomy for Cancer

Postoperative adjuvant chemotherapy is known to be effective for survival in advanced gastric cancer. However, some severe gastrointestinal side effects during chemotherapy can interrupt adjuvant therapy. A 47-year-old woman underwent laparoscopic total gastrectomy for advanced stomach cancer (T4N2M0: Stage IIIB). Cisplatin and 5-fluorouracil chemotherapy was started postoperatively. During the third course of chemotherapy (on the postoperative 102 day) some gastrointestinal content including bile appeared through the healed laparoscopic trocar site. Computed tomography revealed a retroperitoneal abscess connected with this fistula. After percutaneous drainage of the abscess, the fistula ceased spontaneously. The patient was evaluated for chemotherapy again. Chemotherapy-induced gastrointestinal fistula can be seen postoperatively and this can interrupt the patient's chemotherapy process.