Pancreaticoduodenectomy for locally advanced gastric cancer.
OBJECTIVE
This study was conducted to evaluate the therapeutic efficacy of pancreaticoduodenectomy (PD) in the patients with locally advanced gastric cancer.


METHODS
25 gastric cancer patients who underwent PD with gastrectomy were analyzed. The indications of PD were 1) suspicion of direct invasion to the pancreas head (n = 15), 2) invasion to duodenal second portion (n = 6), 3) both pancreatic and duodenal invasion (n = 3), and 4) conglomerated lymph node enlargement around the pancreas head (n = 1).


RESULTS
Mean operation time was 349.5 (+/- 86.5) minutes and mean amount of RBC transfusion was 3.4 (+/- 2.1) pints. Postoperative complications were encountered in 8 patients (32%), but re-operation was required only in 2 cases. No postoperative 30-day mortality occurred after PD. Overall the median survival was 16.5 months with a 5-year survival rate of 15.8%. Two patients with T2bN0M0 and T2bN1M0 stages were still alive for 11.5 years and 5.7 years without any evidence of cancer recurrence.


CONCLUSIONS
Considering the acceptable postoperative morbidity rate and the long-term survivors in selected cases, PD could be considered as one of the therapeutic options for locally advanced gastric cancer.
Lee
Hyuk-Joon
HJ
Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Park
Do Joong
DJ
Lee
Kuhn Uk
KU
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome