A Case of Early Gastric Cancer after Pylorus-preserving Pancreatoduodenectomy

Abstract

We report a case of early gastric cancer after pylorus-preserving pancreatoduodenectomy (PpPD). A 72-year-old man underwent UGI and gastrofiberscopy in follow-up after PpPD for pancreatic head cancer (mucinous cystadenocarcinoma) 4 years earlier. In gastrofiberscopy, IIa+IIc lesion was observed in the major curvature of the antrum, occupying 2 cm of the distal side apart from the pancreaticogastrostomy. A diagnosis of gastric cancer was made preoperatively, and distal gastrectomy conducted with B-II reconstruction for preserving the pancreaticogastrostomy. Microscopic examination showed moderately differentiated adenocarcinoma limited to the submucosal layer without lymphatic metastasis. Given increasing PpPD, the preserved stomach should be followed up carefully.