title: Surgical management of malignant bowel obstruction in recurrent pancreatic cancer.
abstract: BACKGROUND
  Malignant bowel obstruction (MBO) is harrowing complication of gastrointestinal cancers. Only a few studies have reported on the surgical roles of bowel obstruction from recurrent pancreatic cancer. We report successfully management for malignant bowel obstruction by palliative surgery for relief of symptoms.
  
  
  METHODS
  A 43 year old man was diagnosed with pancreatic tail cancer. After distal pancreatectomy, he underwent six cycle of adjuvant chemotherapy. 10 months later, he had suffered from small bowel obstruction by seeding metastases. We performed segmental small bowel resection. This patient had good recovery and continued to receive palliative chemotherapy. A 78 year old man was diagnosed with unresectable, huge pancreatic cancer. He had recurrent obstructive symptoms and periumbilical pain. We decided palliative surgery of wide excision of umbilical abdominal mass for pain control. 3 weeks later, he presented with recurrent symptoms in previous op site. We planned 2nd operation for relief of symptoms. He underwent surgery to resect abdominal wall mass and small bowel due to 2cm sized mass in terminal ileum. After 2nd surgery, he received consistently palliative chemotherapy with good clinical condition.
  
  
  CONCLUSIONS
  Palliative surgery improves quality of life in recurrent pancreatic cancer patients and can continue patient's palliative management. In selected patients, palliative surgery may effective management for progress of survival and quality of life.
authors.affiliation: Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
authors.forename: Hyung Sun
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.affiliation: Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
authors.forename: Ja Hoon
authors.initials: JH
authors.lastname: Back
authors.affiliation: Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Korea. Electronic address: yds6110@yuhs.ac.
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
keywords: Malignant bowel obstruction; Palliative surgery; Pancreatic cancer