Following the presented spleen preserving laparoscopic distal pancreatectomy technique, there is not necessary to enter the lesser sac by dividing the gastrocolic
ligament, in order to mobilize the pancreas.
It is important to schedule defecation the same time every day to take advantage of natural body rhythms and the gastrocolic
reflex (Paris et al., 2011).
Food in the stomach triggers the gastrocolic
reflex, which means that something in the first part of the gastrointestinal tract triggers an increased activity in the last part.
Factors contributing to constipation are numerous, but foremost are the neurologic dysfunctions of decreased gastrointestinal motility and loss of gastrocolic
Motor activity in the colon is strongly stimulated following ingestion of a meal via the gastrocolic
Late presentation of a gastrocolic
fistula after percutaneous flouroscopic gastrostomy.
Tenesmus and increased gastrocolic
reflex were also very common symptoms being complained of by 44% and 41% of cases respectively.
ligament was opened and short gastric vessels were divided using a harmonic dissector (Figure-1).
(2.) Shaik AS, Singh B, Haffejee AA: Gastrocolic
fistula as a complication of benign gastric ulcer.
Major complications resulting from PEG tube placement reported in the literature include peritonitis, haemorrhage, Buried Bumper syndrome and gastrocolic
fistula.13 Only 3 patients (2.2%) in our study had PEG related major complications.
To fully assess the pancreas, the lesser sac is entered through the gastrocolic
omentum outside the gastroepiploic arcade4 and, by retracting the transverse colon inferiorly and the stomach superiorly, exposure of the anterior surface and the superior and inferior borders of the body and tail of the pancreas is obtained.
Surgery confirmed gastrocolic
and jejunocolic fistulas requiring intestinal resection and diversion.