Abstract
We report on the significance of less invasive surgery for a patient who suffered from malnutrition and decreased performance status.
Previously, the patient had undergone a total gastrectomy for gastric cancer, a right hemicolectomy for multiple colonic cancer, and a lower lobectomy for pulmonary actinomycosis.
During the follow-up period, an endoscopic study discovered multiple early duodenal cancers. Considering his poor general condition, intentional nutritional support was performed for 2 months before surgery, after which a pancreas-sparing duodenectomy was carried out as a less invasive procedure. A cholecystectomy revealed an incidental gallbladder cancer with lymph node metastasis, but neither additional nodal dissection nor pancreaticoduodenectomy were performed. He was discharged from the hospital on the 27th day after surgery. The appropriate nutritional support and less invasive surgery is the treatment of choice in patients with poor general condition after multiple gastrointestinal surgery.
