Abstract
A 70-year-old man with bile duct cancer underwent pancreatico-duodenectomy in May, 2002. Pathological findings revealed lymph node metastasis and tumor infiltration to the pancreas head. Twenty-three months after surgery, a local recurrence was pointed out and he was treated with gemcitabine (GEM) with his informed consent. However, repeated fever frequently occurred as of January 2005, and abdominal CT revealed the increased massive recurrent tumor and dilated jejunal loop. Since we diagnosed the patient as jejunal loop obstruction due to recurrent tumor, we performed side to side anastmosis of the afferent and efferent loop. After this operation, he underwent treatment with TS-1 for 17 consecutive months. Because ascites increased and ingestion became difficult, the treatment was changed to best supportive care, and he died at April 2007, 58 months after his first operation.
