Antegrade Jejunal Intussusception at the Bilopancreatic Limb Jejunojejunostomy After Laparoscopic Distal Gastrectomy With Roux-en-Y Reconstruction: A Case Report.

Jejunal intussusception is a rare but potentially serious complication of gastric surgery, typically involving the gastrojejunostomy or alimentary limbs. A 75-year-old woman underwent laparoscopic distal gastrectomy with D1+ lymphadenectomy and Roux-en-Y reconstruction for early-stage gastric cancer. Postoperatively, she developed intermittent vomiting every 10 days without identifiable triggers and was managed conservatively. However, transient jejunal intussusception involving the bilopancreatic limb was later identified at the jejunojejunal site. Although the intussusception resolved spontaneously, her symptoms persisted. Laparoscopic reoperation revealed mild bulging at the jejunojejunostomy site and a bilopancreatic limb measuring approximately 40 cm, considerably longer than the intended 25 cm. The segment was resected and reconstructed in the antiperistaltic direction using a 25-cm limb. Postoperatively, the patient's symptoms resolved completely. Even minor intraoperative misjudgment of bilopancreatic limb length may lead to functional complications such as intussusception. Awareness of this rare complication can help guide surgical decision-making and postoperative management, ultimately improving patient outcomes.