Anastomotic Leakage from Esophagojejunostomy After Gastrectomy Classification

 

Identification of a leak may involve:

(1) methylene blue or other nontoxic dye administered orally

(2) oral contrast media with imaging study

 

Types of anastomotic leakage:

(1) subclinical (type I)

(2) clinical (type II)

 

Subclinical - local collection with all of the following:

(1) no spillage into the peritoneal cavity

(2) no spillage into the pleural cavity

(3) no dye or contrast material from any of the abdominal drains

(4) no septic complications

 

Clinical - one or more of the following:

(1) spillage into the peritoneal cavity

(2) spillage into the pleural cavity

(3) dye or contrast material in any of the abdominal drains

(4) other leakage or dissemination

(5) septic complications

 

Mortality was 5% with a type I leak vs 78% for a type II.