Skip to main content

Advertisement

SpringerLink
Log in

Total pancreatectomy preserving the right gastroepiploic artery following proximal gastrectomy

  • Case report
  • Published:
International Cancer Conference Journal Aims and scope Submit manuscript

Abstract

Total pancreatectomy (TP) after proximal gastrectomy (PG) requires more attention than ordinary TP during surgery in terms of the preservation of blood flow to the remnant stomach that was supplied via only the right gastric and gastroepiploic arteries. The current report presents the details of a case in which the remnant stomach was safely preserved when performing TP. A 74-year-old man who underwent PG for gastric cancer 17 years previously was diagnosed with pancreatic head cancer during follow-up for intraductal papillary mucinous neoplasm of the pancreatic body and tail. To preserve digestive function and reduce postoperative complications, TP preserving the right gastroepiploic artery and splenic vessels was performed. The remnant stomach and function were safely preserved without any complications after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Availability of data and materials

The data are not available for public access because of the patient privacy concerns but are available from the corresponding author on reasonable request.

Abbreviations

CT:

Computed tomography

DGE:

Delayed gastric emptying

ERCP:

Endoscopic retrograde cholangiopancreatography

GDA:

Gastroduodenal artery

GVC:

Gastric venous congestion

ICG:

Indocyanine green

IPMN:

Intraductal papillary mucinous neoplasm

NAC:

Neoadjuvant chemotherapy

PD:

Pancreatoduodenectomy

PDAC:

Pancreatic ductal adenocarcinoma

PG:

Proximal gastrectomy

PGV:

Posterior gastric vein

PNI:

Prognostic nutritional index

RGA:

Right gastric artery

RGEA:

Right gastroepiploic artery

RGEV:

Right gastroepiploic vein

TP:

Total pancreatectomy

References

  1. Sharma A, Mukewar S, Chari ST, Wong Kee Song LM (2017) Clinical features and outcomes of gastric ischemia. Dig Dis Sci 62(12):3550–3556

    Article  PubMed  Google Scholar 

  2. Fragulidis GP, Athanasopoulos PG, Melemeni A, Chondrogiannis KD, Nastos K, Koutoulidis V et al (2011) Pylorus-preserving pancreaticoduodenectomy after transhiatal esophagectomy sparing the right gastroepiploic vessels and gastric tube. J Gastrointest Surg 15(2):367–370

    Article  PubMed  Google Scholar 

  3. Inoue A, Akita H, Eguchi H, Hama N, Wada H, Kawamoto K et al (2014) Gastric conduit-preserving, radical pancreaticoduodenectomy with microvascular reconstruction for pancreatic head cancer after esophagectomy: report of a case. Surg Today 44(4):786–791

    Article  PubMed  Google Scholar 

  4. Nandy N, Dasanu CA (2014) Second primary pancreatic adenocarcinoma three years after successfully treated index esophageal cancer. JOP J Pancr 15(1):46–48

    Google Scholar 

  5. Okochi M, Ueda K, Sakaba T, Kenjo A, Gotoh M (2015) Right gastro-omental artery reconstruction after pancreaticoduodenectomy for subtotal esophagectomy and gastric pull-up. Int J Surg Case Rep 15:42–45

    Article  PubMed  PubMed Central  Google Scholar 

  6. Orii T, Yoshimura M, Kitahara H, Karasawa Y (2019) Pylorus-preserving pancreatoduodenectomy for pancreatic head cancer after surgery for esophageal cancer with gastric tube reconstruction in a long-term survivor: a case report. Int J Surg Case Rep 55:92–98

    Article  PubMed  PubMed Central  Google Scholar 

  7. Izumi H, Yoshii H, Abe R, Yamamoto S, Mukai M, Nomura E et al (2019) Pancreaticoduodenectomy following surgery for esophageal cancer with gastric tube reconstruction: a case report and literature review. Surg Case Rep 5(1):191

    Article  PubMed  PubMed Central  Google Scholar 

  8. Appelbaum R, Kuehler DC, Brodsky J (2020) Pylorus preserving pancreaticoduodenectomy after prior esophagogastrectomy. J Pancreat Cancer 6(1):116–118

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hirashita T, Iwashita Y, Nakanuma H, Tada K, Saga K, Masuda T et al (2019) Pylorus-preserving pancreatoduodenectomy preserving the right gastroepiploic vessels following proximal gastrectomy: report of two cases. Surg Case Rep 5(1):41

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kaneko T, Sugihara S, Kobayashi H, Harada H, Ikuta Y, Egami T et al (2000) An operative case of a mucin producing pancreatic tumor 9 years after the first operation of esophageal and pulmonary cancers. Jpn J Gastroenterol Surg. 33:735–739

    Article  Google Scholar 

  11. Yada K, Matsumoto T, Kusano T, Masuda T, Takeuchi H, Hayashi H et al (2010) A case of duodenal cancer treated successfully by gastric tube-preserving pancreatoduodenectomy after esophagectomy. Jpn J Gastroenterol Surg 43:385–390

    Article  Google Scholar 

  12. Loos M, Mehrabi A, Ramouz A, Contin P, Strobel O, Muller-Stich BP et al (2021) Gastric venous congestion after total pancreatectomy is frequent and dangerous. Ann Surg 2:2

    Google Scholar 

Download references

Acknowledgements

Source of funding is not applicable. The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

This case report did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, 730-0052, Japan

    Kyohei Yugawa, Naoto Kojo, Shohei Yamaguchi, Shigeyuki Nagata & Takashi Maeda

Authors
  1. Kyohei Yugawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naoto Kojo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shohei Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigeyuki Nagata
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KY and TM designed the surgical concept and performed the surgery. KY, NK, SY, and SN carried out the acquisition of data and drafted the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takashi Maeda.

Ethics declarations

Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The present case report was conducted in accordance with the ethical standards of our institution. A written general consent form was obtained for this patient.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yugawa, K., Kojo, N., Yamaguchi, S. et al. Total pancreatectomy preserving the right gastroepiploic artery following proximal gastrectomy. Int Canc Conf J 12, 153–159 (2023). https://doi.org/10.1007/s13691-023-00596-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13691-023-00596-9

Keywords

Search

Navigation