A CASE REPORT OF COLON CANCER CURATIVELY RESECTED BY PYLORUS-PRESERVING PANCREATODUODENECTOMY AND RIGHT HEMICOLECTOMY

Abstract

A case of colon cancer with malignant duodenocolic fistula which was curatively resected by pylorus-preserving pancreatoduodenectomy (PPPD) and right hemicolectomy is described. A 60-year-old man complained of vomiting and diarrhea. Barium meal, barium enema, computed tomography and other radiological examinations were performed, and the patient was diagnosed as having a carcinoma of the transverse colon with direct invasion to the third portion of the duodenum and malignant duodenocolic fistula. Right hemicolectomy and PPPD were performed at a time to achieve en-bloc resection of the lesion with regional lymph nodes dissection. Microscopic examination showed no lymph node metastasis. We could perform absolute curative resection. Postoperative course was uneventful, and he is getting well as of one year after the operation, with good nutritional state and no evidence of recurrence.
In this paper our indications, some devices for surgical technique and postoperative management of PPPD, as well as importnat points for surgical procedure applied to this case are discussed.