title: [A Case of Adenocarcinoma of the Vater Papilla Treated with Pancreatoduodenectomy after Hepaticojejunostomy for Prior Adenocarcinoma of the Gallbladder].
abstract: A 77-year-old man was diagnosed with acute cholecystitis and underwent laparoscopic cholecystectomy. Since adenocarcinoma in the gallbladder was detected by histopathological examination, he received additional resection for the carcinoma: partial hepatectomy(S4a, S5), extrahepatic bile duct resection, and hepaticojejunostomy. Five years after the surgery, he was diagnosed with adenocarcinoma of the Vater papilla. Pancreatoduodenectomy was performed. During the surgery, the prior hepaticojejunostomy and jejunojejunostomy were preserved, and the gastrointestinal tract was cut at the stomach and jejunum 5 cm from the Treitz ligament. A postoperative pancreatic fistula developed, but it resolved. The method of reconstruction in this case has the advantage of not only a smaller number of resections and anastomoses of the gastrointestinal tract but also a better preservation of blood flow in the jejunum compared to other methods reported in previous studies.
authors.affiliation: Dept. of Surgery, Toyonaka Municipal Hospital.
authors.forename: Yu
authors.initials: Y
authors.lastname: Takeda
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Kozo
authors.initials: K
authors.lastname: Noguchi
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Nagase
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hamabe
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirota
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Oshima
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tanida
authors.forename: Tomono
authors.initials: T
authors.lastname: Kawase
authors.forename: Shunji
authors.initials: S
authors.lastname: Morita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwazawa
authors.forename: Kenzo
authors.initials: K
authors.lastname: Akagi
authors.forename: Shiro
authors.initials: S
authors.lastname: Adachi
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D000368:Aged; D013505:Digestive System Surgical Procedures; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000556:secondary / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D016896:Treatment Outcome