Rapid progressive long esophageal stricture caused by gastro
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Delayed gastric emptying (DGE) is a major postoperative complication after pylorus-preserving pancreatoduodenectomy (PpPD) and sometimes causes reflux esophagitis. In most cases, this morbidity is controllable by a proton-pump inhibitor (PPI) and very rarely results in esophageal stricture. Balloon dilation is usually performed for benign esophageal stricture and esophagectomy was rarely elected. In the present case, there were two important problems of surgical procedure; how to perform esophageal reconstruction after PpPD and whether to preserve the stomach or not.A 63-year-old man underwent PpPD and Child reconstruction with Braun anastomosis for lower bile duct carcinoma. Two weeks after surgery DGE occurred and a 10 cm long stricture from middle esophagus to cardia developed one and a half month after surgery in spite of the administration of antacids...

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