Complications requiring reoperation after gastrectomy for gastric cancer: 17 years experience in a single institute.

<bold>Introduction: </bold>Morbidity and mortality rates following gastric cancer surgery are still high. The present study documented complications requiring reoperation after gastrectomy for gastric cancer and described surgical management for each complication.<bold>Materials and Methods: </bold>Between 1987 and 2004, 8,033 patients underwent gastrectomy at the Department of Surgery, College of Medicine, Yonsei University, and the records were reviewed.<bold>Results and Discussion: </bold>The most frequent complication was intestinal obstruction (88 patients, 54.3%), followed by intraabdominal bleeding (15, 9.3%), wound dehiscence or evisceration (15, 9.3%), incisional hernia (15, 9.3%), anastomotic leakage (seven, 4.2%), acalculous cholecystitis (five, 3.1%), duodenal stump leakage (five, 3.1%), intraabdominal abscess without leakage (five, 3.1%), bowel perforation (five, 3.1%), bile peritonitis due to hepatic duct injury (one, 0.6%), and biliary stricture (one, 0.6%). There were ten cases of hospital mortality (6.2%) from intraabdominal bleeding (four patients), intestinal obstruction (four patients), and anastomotic leakage (two patients). The most common long-term complication requiring reoperation was intestinal obstruction (69, 75.8%) due to adhesive formation rather than technical failure, while short-term complications were surgery-related and associated with high hospital mortality (14.1%).<bold>Conclusion: </bold>Proper preoperative preparation and faultless surgical skills are required during initial surgery to reduce complications and the need for reoperation. [ABSTRACT FROM AUTHOR]