Abstract
Aims : To evaluate the safety and feasibility of total pancreatectomy for recurrent pancreatic cancer in the remnant pancreas (TP), and determine the advantages of pancreatogastrostomy in the diagnosis of recurrence. Methods : From January 1998 to March 2016, three patients with pancreatic ductal adenocarcinoma (PDA) and three patients with intraductal papillary mucinous carcinoma (IPMC) underwent TP at Toranomon Hospital. Clinicopathological data, perioperative outcomes, and overall survival were assessed. Results : Five patients underwent pancreaticoduodenectomy with pancreatogastrostomy, and four underwent distal pancreatectomy together with splenectomy as their initial pancreatic operation. All patients who underwent pancreatogastrostomy were diagnosed with recurrence in the remnant pancreas by endoscopic examination. The median operation time was 192 minutes, and blood loss was 1250 mL. No serious complications occurred. One of the three patients who had PDA died of cancer in the 9th postoperative month. Survival for the other two patients was 17 months and 47 months. Two of the three patients who had IPMC died of cancer in the 44th and 49th postoperative month, and the survival of the other patient was 133 months without relapse. Conclusion : TP is safe and may improve overall survival, and pancreatogastrostomy is advantageous for the diagnosis of recurrence in the remnant pancreas.
