Background: Gastrectomy for cancer is a technically demanding procedure, with postoperative complications reported to be in the range of 20%-46%. Of all the post-gastrectomy morbidity anastomotic leak and duodenal stump blow-out are some of the most uncommon but serious complications. Post-gastrectomy anastomotic leak would lead to prolonged hospital stay, increased surgery-related costs, mortality and is expected to be related to poor long-term quality of life. The leak rates vary from 5% to 14%. Postoperative (in-hospital) death after anastomotic leak following total gastrectomy varies from 19 to 62% in literature.

Methodology: This study reviewed the medical records of 176 patients who underwent potentially curative gastrectomy for gastric adenocarcinoma in a tertiary care hospital.

Result: Total of 176 patients underwent curative gastrectomy for gastric adenocarcinoma during this period, 130 (73.9%) underwent Distal/subtotal gastrectomy, 12 (6.8%) had Proximal gastrectomy and remaining 34 (19.3%) underwent Total gastrectomy. 22 out of 176 (12.5%) had anastomotic leak (including duodenal stump leak). On univariate analysis, pulmonary complications were predictor of anastomotic leak but on multivariate analysis, these were not independent predictors of anastomotic leak. Other factors like age, gender, comorbidities, addictions, Preoperative anaemia, Hypoalbuminemia, preoperative nutrition, pre-operative chemotherapy or radiotherapy, previous laparotomy, tumour location, extent of surgery, type of reconstruction, technique of anastomosis, GJ position, extent of LN dissection, combined organ resection, T stage, N stage, number of LN harvested, number of positive LN, R status were not significantly contributed to anstomotic leak.

Conclusion: As opposed to usual belief of a surgeon, neoadjuvant chemotherapy or radiotherapy, extent of surgery, type of reconstruction, technique of anastomosis, stage of tumour and R status didn’t effect the anastomotic leak of gastrectomy for gastric adenocarcinoma.