A Case of Synchronous Advanced Gastric Cancer and Intraductal Papillary Mucinous Carcinoma Treated with Combined Distal Gastrectomy and Splenic Artery and Vein-preserving Total Pancreatectomy

Abstract

A 73-year-old man who underwent computed tomography to investigate pyelonephritis was diagnosed with intraductal papillary mucinous carcinoma (IPMC) in the main pancreatic duct and advanced cancer of the gastric pylorus. Since combined distal gastrectomy and total pancreatectomy might have caused problems, including insufficient arterial perfusion to the remnant stomach and venous stasis, it was therefore decided to carry out combined distal gastrectomy and splenic artery and vein-preserving total pancreatectomy. Although patients requiring both distal gastrectomy and pancreatectomy including splenic artery division are sometimes encountered in clinical practice, and cases in which both types of radical resection were performed separately for metachronous disease have been reported, no case of combined distal gastrectomy and splenic artery and vein-preserving total pancreatectomy has been previously reported. This case is presented along with a discussion of the literature.