RT Journal Article
SR Electronic
T1 Pancreatoduodenectomy for distal cholangiocarcinoma 13 years after oesophagectomy with gastric tube reconstruction: report of a case
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e246852
DO 10.1136/bcr-2021-246852
VO 15
IS 2
A1 Biesma, Nanske C
A1 te Riele, Wouter W
A1 Van Santvoort, Hjalmar C
A1 Molenaar, I Quintus
YR 2022
UL http://casereports.bmj.com/content/15/2/e246852.abstract
AB Advancements in cancer management have led to improved survival in patients with oesophageal cancer. This has resulted in an increased incidence of second primary malignancies with the pancreas as a common secondary cancer site. Resectable pancreatic and periampullary cancers are treated by pancreatoduodenectomy, including resection of the gastroduodenal artery which provides the blood supply to the gastric conduit in patients who underwent oesophagectomy. A 77-year-old man with a history of distal oesophageal cancer, for which an oesophagectomy with gastric tube reconstruction was performed, presented in the emergency department. Extensive workup showed a lesion suspected for a distal cholangiocarcinoma. Pancreatoduodenectomy was deemed feasible after arterial angiography revealed that the gastric conduit was dominantly vascularised by the right gastric artery. Adequate imaging of the blood supply is essential to determine eligibility for pancreatoduodenectomy in patients with a second primary malignancy in the pancreas or periampullary region after oesophagectomy with gastric tube reconstruction.