A 49-year-old male visited at our hospital with a major complaint of epigastric pain. After close examination, cancer of the pancreatic body with infiltration into the celiac artery and the portal vein was revealed. One month later, transcatheter arterial embolization of the common hepatic artery was performed prior to surgery, and 1 week later, DP-CAR, the concomitant resection of the portal vein, and a partial transverse colectomy were performed. The pathological examination showed Stage IVa. Approximately 1 month after surgery, peritonitis due to gastric perforation occurred, and closure of the perforation via sutures and a drainage procedure were performed. After recovery, postoperative adjuvant chemotherapy was initiated using gemcitabine, and the patient was then discharged. Subsequently, no local recurrence was observed, but hepatic metastases occurred at S5 and S6, so radiofrequency ablation was performed. Combination therapy was performed thereafter, however, the patient died 25 months after the surgery. Until then, no cancer-related pain or refractory diarrhea was observed, and the patient worked and spent most of his time at home until 1 month before his death. DP-CAR is a newly designed extended surgical procedure, so it can be a choice of treatment for locally advanced pancreatic cancer.
View full abstract