Pancreaticoduodenectomy for gastric Cancer

Byun, Jae Cheol; Lee, Joo Ho; Yu, Hang Jong; Kim, Soo Jin; Lee, Kuhn Uk; Kim, Jin Pok

Abstract

PURPOSE
We purpose of this retrospective study is to evaluate the role of pancreaticoduadenectomy (PD) in gastric cancer which invades neighboring organs.
MATERIALS AND METHODS
We analysed 28 patients with locally advanced gastric cancer which invaded to pancreas and/or duodenum who received surgical resection from Jan. 1989 to Dec. 1996. Patients were divided into two groups: Group A (n=12) who received PD and Group B (n=16) who received gastrectomy only. Indication of PD in group A is locally advanced gastric cancer which invaded to pancreas and/or duodenum but had no evidence of widespread nodal involvement, extended hepatic metastasis, or peritoneal dissemination.
RESULTS
The operation time, amount of blood loss during operation, and postoperative hospital stay were greater in group A than in group B. Operative mortality was found in 1 case in group B but none in group A. Postoperative complications were similar in both groups. Four patients had liver metastases in both group during follow up period, whereas 2 and 4 patients had disseminated peritoneal seeding in group A and B, respectively. When survival rates were compared, Group A shows better survival than Group B (p= 0.043).
CONCLUSION
These results suggest that PD is a rational and safe method for treatment of gastric cancer infiltrating into pancreatic head and/or duodenum.