Laparoscopic completion total gastrectomy for remnant gastric cancer following pancreaticoduodenectomy for bile duct cancer: a case report.
Laparoscopic completion total gastrectomy for remnant gastric cancer following pancreaticoduodenectomy for bile duct cancer: a case report.
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DOI：
10.4174/astr.2016.90.2.106
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发表时间：
2016-02
影响因子：
1.4
通讯作者：
Kim W
中科院分区：
文献类型：
--
作者：
Kim DJ;Kim W
尚未报告胰腺癌切除术（PD）后腹腔镜完成全胃切除术。一名73岁男性，25年前因远端胆总管癌接受PD，因残胃癌就诊于外科。先前的重建采用胰肠吻合术（PJ）、胃空肠吻合术和Braun吻合术，即，空肠空肠吻合术（JJ），在输入和输出空肠分支之间，以防止胆汁回流到残胃中。最初进行粘连松解术以固定手术视图。进行脾动脉、脾门、腹腔轴、胃左动脉和肝总动脉周围的淋巴结解剖。PJ部位可视化良好且安全保存。使用OrVil系统进行食管空肠吻合术。通过延长的脐套管针部位进行标本取出、Roux肢体准备和JJ。最后的病理检查显示一个5.5厘米的浆膜暴露的肿瘤（T4a）没有淋巴结转移。患者于术后第7天出院，无任何并发症。
Laparoscopic completion total gastrectomy following pancreaticoduodenectomy (PD) has not been reported. A 73-year-old male who underwent PD 25 years ago for distal common bile duct cancer visited a surgical department for remnant gastric cancer. A previous reconstruction was performed with pancreaticojejunostomy (PJ), gastrojejunostomy and Braun anastomosis, i.e., jejunojejunostomy (JJ), between the afferent and efferent jejunal limb to prevent bile reflux into the remnant stomach. Adhesiolysis was initially performed to secure the surgical view. Lymph node dissections around the splenic artery, splenic hilum, celiac axis, left gastric artery, and common hepatic artery were performed. The PJ site was well visualized and safely preserved. Esophagojejunostomy was performed with an OrVil system. Specimen retrieval, Roux-limb preparation and JJ were performed through an extended umbilicus trocar site. A final pathologic examination revealed a 5.5-cm serosa-exposed tumor (T4a) without lymph node metastasis. The patient was discharged on postoperative day 7 without any complications.