Total Stomach-Preserving Duodenojejunostomy for Unresectable Cancer of the Head of the Pancreas

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  • 切除不能膵頭部癌に対する全胃温存十二指腸空腸吻合術
  • セツジョ フノウ スイトウブ ガン ニタイスル ゼンイ オンゾン ジュウニシチョウ クウチョウ フンゴウジュツ
  • 症例報告 切除不能膵頭部癌に対する全胃温存十二指腸空腸吻合術
  • ショウレイ ホウコク セツジョ フノウスイトウブガン ニ タイスル ゼン イ オンゾン ジュウニシチョウ クウ チョウ フンゴウジュツ

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Abstract

A man in his fifties presenting with jaundice was admitted to our hospital. A detailed examination revealed cancer of the head of the pancreas. While performing a laparotomy, the tumor was found to be unresectable because of metastasis to the para-aortic lymph nodes. Therefore, a choledochojejunostomy and total stomach-preserving duodenojejunostomy were performed. The duodenojejunostomy was performed distal to the jejunojejunostomy so that it was some distance away from the tumor. After surgery, the patient made a good, functional recovery and subsequently survived for 2 years and 5 months with the aid of chemotherapy. Total stomach-preserving duodenojejunostomy may be a useful method of palliative surgery for the treatment of unresectable cancer of the head of the pancreas, because it enables the maintenance of adequate oral intake for a longer period compared with that with a gastrojejunostomy, even in the presence of tumor enlargement or invasion.

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