Pylorus Preserving Pancreaticoduodenectomy After Prior Esophagogastrectomy.

Publication/Presentation Date

1-1-2020

Abstract

Background: As treatment of esophageal carcinomas continues to improve, we have seen an increasing population of long-term survivors giving rise to the observation of additional primary malignancies not previously seen. Esophagogastrectomy for previously treated esophageal carcinoma presents unique anatomic changes providing further technical difficulties for surgical management of new primary malignancies. Presentation: A 65-year-old male with a history of esophagogastrectomy for esophageal adenocarcinoma presents with a pancreatic head mass consistent with pancreatic adenocarcinoma. Our case report describes a pylorus sparing pancreaticoduodenectomy with preservation of the right gastric and right gastroepiploic vessels in order to preserve blood supply to the gastric conduit. Conclusion: Here we demonstrate that in select cases where location of the pancreatic head tumor is favorable, pancreaticoduodenectomy can be performed in the context of prior esophagogastrectomy with preservation of the native blood supply to the gastric conduit. Pancreaticoduodenectomy may have yet been possible if the tumor involved the gastroduodenal artery via vascular reconstruction to the right gastroepiploic artery or sacrifice of the gastric conduit with reconstruction using small or large intestine.

Volume

6

Issue

1

First Page

116

Last Page

118

ISSN

2475-3246

Disciplines

Medicine and Health Sciences | Surgery

PubMedID

33376938

Peer Reviewed for front end display

Peer-Reviewed

Department(s)

Department of Medicine, Hematology-Medical Oncology Division, Department of Surgery, Department of Surgery Residents, Fellows and Residents

Document Type

Article

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