Postoperative Complications of Oncological Gastrectomies: A Case Series

Abstract

Oncologic gastrectomy is the only potentially curative treatment for gastric cancer, although it is associated with high postoperative morbidity and mortality. Early diagnosis of complications is essential to reduce mortality and guide timely therapeutic decisions. This paper presents a series of representative cases, grouped in a pictorial review of postoperative complications after oncologic gastrectomy, with emphasis on computed tomography findings. Early complications included bleeding at the entero-enteric anastomosis, anastomotic leakage, entero-quilloid fistula, acute pancreatitis, and omental infarction. Late complications included hiatal hernia complicated by intestinal obstruction, tumor recurrence at the anastomosis and peri-anastomotic ulcer. Multidetector computed tomography enabled us to accurately identify fluid collections, contrast extravasation, dilated loops and inflammatory or ischemic changes, providing direct and indirect signs of complications. These findings were decisive in guiding treatment, whether conservative, interventional, or surgical. This case series highlights the usefulness of computed tomography in the early recognition of potentially serious complications, reinforcing its role as an essential diagnostic tool in the postoperative follow-up of oncologic gastrectomy.