Ann Hepatobiliary Pancreat Surg.  2020 Nov;24(4):542-546. 10.14701/ahbps.2020.24.4.542.

Laparoscopic repeated pancreatectomy for isolated local recurrence in remnant pancreas following laparoscopic radical pancreatectomy for pancreatic ductal adenocarcinoma: Two cases report

Affiliations
  • 1Division of Hepatobiliary and Pancreatic Surgery, Severance Hospital, Seoul, Korea
  • 2Department of Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
  • 3Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea

Abstract

Typical treatment for recurrent pancreatic cancer is potent chemotherapy or chemoradiotherapy. However, recent clinical investigations suggest a potential therapeutic role of local resection in recurrent pancreatic cancer. Based on accumulating surgical experience of minimally invasive pancreatectomy, we report cases of two patients who underwent successful laparoscopic re-resection of isolated local recurrence following laparoscopic radical pancreatectomy for pancreatic cancer.

Keyword

Laparoscopy; Pancreatic neoplasms; Pancreatectomy; Neoplasm recurrence; Local

Figure

  • Fig. 1 Perioperative findings. Recurrent pancreatic cancer was noted on remnant pancreas (A). The pancreatic neck was fully mobilized from the SMV-PV- SV confluence (B). Combined gastric wedge resection (thin white arrow) was performed (C). The splenic artery was dissected and resected by endo-GIA (yellow arrow), and the splenic vein was also ligated (thick arrow, D). T, tumor area in remnant pancreas; P, pancreatic neck; SMV, superior mesenteric vein; SV, splenic vein; S, stomach; CHA, common hepatic artery.

  • Fig. 2 Perioperative findings. Recurrent pancreatic cancer at the pancreaticojejunostomy (PJ) site (white arrow, A). The jejunum was resected near PJ site (B). Tumor was dissected from the superior mesenteric artery. The splenic artery was ligated with vascular endo GIA (yellow arrow, C). Gross findings of recurrent tumor at the PJ site (white arrow, D). CHA, common hepatic artery; SA, splenic artery; PJ, previous pancreaticojejunostomy site; J, proximal jejunum after resecting previous Roux-en-Y limb for PJ; SMA, superior mesenteric artery.


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