Back to Search
Start Over
Pancreaticoduodenectomy following total gastrectomy: a case report and literature review.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2014 Mar 14; Vol. 20 (10), pp. 2721-4. - Publication Year :
- 2014
-
Abstract
- We present a case of afferent loop syndrome (ALS) occurring after pancreaticoduodenectomy (PD) in a patient who had previously undergone total gastrectomy (TG), and review the English-language literature concerning reconstruction procedures following PD in patients who had undergone TG. The patient was a 69-year-old man who had undergone TG reconstruction by a Roux-en-Y method at age 58 years. The patient underwent PD for pancreas head adenocarcinoma. A jejunal limb previously made at the prior TG was used for pancreaticojejunostomy and hepaticojejunostomy. Despite normal patency of the hepaticojejunostomy, he suffered from repeated postoperative cholangitis which was brought on by ALS due to shortness of the jejunal limb (15 cm in length). We therefore performed receliotomy in which the hepaticojejunostomy was disconnected and reconstructed using a new Y limb 40-cm in length constructed in a double Roux-en-Y fashion. The refractory cholangitis resolved immediately after the receliotomy and did not recur. Review of the literature revealed the lack of any current consensus for a standard procedure for reconstruction following PD in patients who had previously undergone TG. This issue warrants further attention, particularly given the expected future increase in the number of PDs in patients with a history of gastric cancer.
- Subjects :
- Adenocarcinoma pathology
Afferent Loop Syndrome diagnosis
Afferent Loop Syndrome surgery
Aged
Anastomosis, Roux-en-Y
Cholangitis etiology
Humans
Male
Pancreatic Neoplasms pathology
Reoperation
Stomach Neoplasms pathology
Treatment Outcome
Adenocarcinoma surgery
Afferent Loop Syndrome etiology
Gastrectomy adverse effects
Pancreatic Neoplasms surgery
Pancreaticoduodenectomy adverse effects
Plastic Surgery Procedures adverse effects
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 20
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 24627609
- Full Text :
- https://doi.org/10.3748/wjg.v20.i10.2721