Abstract
A 91-year-old woman with a history of esophageal cancer at age 75 years, for which she underwent subtotal esophageal resection and retrosternal gastric tube reconstruction, was referred to our hospital for evaluation of obstructive jaundice and diagnosed with ampulla of Vater carcinoma. Preoperative imaging studies indicated that a pancreaticoduodenectomy (PD) with preservation of gastric tube blood flow was possible. Although the patient was very elderly, her general condition, including activities of daily living (ADL) and performance status (PS), was good, indicating that surgery could be tolerated. Therefore, surgery was performed.
With the aging of society and improved surgical outcomes, the need for complicated surgery such as PD in elderly persons, similar to the present patient, after surgery for other types of cancer is expected to increase. Decisions regarding treatment strategy that may include surgery in very elderly patients require a comprehensive assessment of potential curability, surgical invasiveness, general condition of the patient, and social background.
This case of gastric tube-preserving PD in this very elderly patient with ampulla of Vater carcinoma after having undergone surgery for esophageal cancer is reported, along with a discussion of the relevant literature.
