Document Detail

Pancreaticoduodenectomy following total gastrectomy: A case report and literature review.
MedLine Citation:
PMID:  24627609     Owner:  NLM     Status:  In-Data-Review    
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.
Satoshi Yokoyama; Akinori Sekioka; Kohei Ueno; Yasuhiro Higashide; Yuko Okishio; Nao Kawaguchi; Takeshi Hagihara; Harumi Yamada; Ryo Kamimura; Michio Kuwahara; Masato Ichimiya; Hirofumi Utsunomiya; Shiro Uyama; Hiroaki Kato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  20     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-03-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  2721-4     Citation Subset:  IM    
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