Laparoscopic completion total gastrectomy for remnant gastric cancer following pancreaticoduodenectomy for bile duct cancer: a case report.
10.4174/astr.2016.90.2.106
- Author:
Dong Jin KIM
1
;
Wook KIM
Author Information
1. Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. kimwook@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Gastrectomy;
Laparoscopy;
Pancreaticoduodenectomy
- MeSH:
Aged;
Arteries;
Axis, Cervical Vertebra;
Bile Duct Neoplasms*;
Bile Ducts*;
Bile Reflux;
Bile*;
Common Bile Duct;
Extremities;
Gastrectomy*;
Gastric Bypass;
Gastric Stump;
Hepatic Artery;
Humans;
Laparoscopy;
Lymph Node Excision;
Lymph Nodes;
Male;
Neoplasm Metastasis;
Pancreaticoduodenectomy*;
Pancreaticojejunostomy;
Splenic Artery;
Stomach Neoplasms*;
Surgical Instruments;
Umbilicus
- From:Annals of Surgical Treatment and Research
2016;90(2):106-110
- CountryRepublic of Korea
- Language:English
-
Abstract:
Laparoscopic completion total gastrectomy following pancreaticoduodenectomy (PD) has not been reported. A 73-year-old male who underwent PD 25 years ago for distal common bile duct cancer visited a surgical department for remnant gastric cancer. A previous reconstruction was performed with pancreaticojejunostomy (PJ), gastrojejunostomy and Braun anastomosis, i.e., jejunojejunostomy (JJ), between the afferent and efferent jejunal limb to prevent bile reflux into the remnant stomach. Adhesiolysis was initially performed to secure the surgical view. Lymph node dissections around the splenic artery, splenic hilum, celiac axis, left gastric artery, and common hepatic artery were performed. The PJ site was well visualized and safely preserved. Esophagojejunostomy was performed with an OrVil system. Specimen retrieval, Roux-limb preparation and JJ were performed through an extended umbilicus trocar site. A final pathologic examination revealed a 5.5-cm serosa-exposed tumor (T4a) without lymph node metastasis. The patient was discharged on postoperative day 7 without any complications.
