title: Gastric conduit-preserving, radical pancreaticoduodenectomy with microvascular reconstruction for pancreatic head cancer after esophagectomy: report of a case.
abstract: Pancreaticoduodenectomy is a radical treatment for pancreatic head cancer. However, it is sometimes difficult to perform pancreaticoduodenectomy, particularly in patients who have previously undergone esophagectomy with gastric conduit reconstruction. We herein describe a surgical technique for radical pancreaticoduodenectomy with microvascular reconstruction that preserves the gastric conduit. A 72-year-old male with a previous history of esophagectomy and gastric conduit reconstruction for esophageal cancer was referred to our hospital for surgical treatment of advanced pancreatic head cancer. After considering both the cancer curability and preservation of the gastric conduit, we performed a standard pancreaticoduodenectomy, and added a microvascular anastomosis of the gastroduodenal artery to the right gastroepiploic artery. In addition, we also performed reconstruction of the right gastroepiploic vein. This radical pancreaticoduodenectomy with microvascular reconstruction was safely and successfully performed, and it preserved the gastric conduit. The 6-month follow-up showed recurrence-free survival and a good quality of life.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2(E2), Suita, Osaka, 565-0871, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Inoue
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Akita
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D006801:Humans; D008297:Male; D016609:Neoplasms, Second Primary / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013270:Stomach / Q000098:blood supply / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D014680:Veins / Q000601:surgery