Abstract
We report a case of pancreatic carcinoma in the pancreaticogastrostomy site after pylorus preserving pancreatoduodenectomy (PpPD). A 75-year-old woman underwent PpPD for cancer of the papilla of Vater. The pancreatic surgical margin of the PpPD specimen was free of cancer cells. Follow-up endoscopy 5 years after PpPD showed an elevated lesion at the pancreaticogastrostomy. Total resection of the remnant pancreas combined with distal gastrectomy and splenectomy were conducted under a diagnosis of pancreatic carcinoma in the remnant pancreas. Histopathological diagnosis was papillary adenocarcinoma of the pancreas (ts4, s0, rpo, pv0, a0, t1b, n0, stage II) Metachronous double cancer of the papilla of Vater and the remnant pancreas curatively resected is extremely rare, and we discuss its differential diagnosis, carcinogenesis, and prognosis.
