A resected case of pancreatic head cancer developing 40 years after lateral pancreaticojejunostomy for chronic pancreatitis

A 72-year-old male patient presented to our department complaining of with upper abdominal pain and jaundice. He had a history of a side-to-side pancreaticojejunostomy performed 40 years previously for chronic pancreatitis. A diagnostic workup revealed a tumor 3 cm in size in the pancreatic head as...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2024-06, Vol.17 (3), p.537-542
Main Authors: Matsumoto, Takatsugu, Tanaka, Genki, Mori, Shozo, Niki, Maiko, Sato, Shun, Shiraki, Takayuki, Iso, Yukihiro, Nagashima, Kazunori, Irisawa, Atsushi, Nozawa, Yumi, Takada-Owada, Atsuko, Ishida, Kazuyuki, Aoki, Taku
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Carcinoma, Pancreatic Ductal - surgery
Case Report
Colorectal Surgery
Gastroenterology
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy - adverse effects
Pancreaticojejunostomy
Pancreatitis, Chronic - complications
Pancreatitis, Chronic - etiology
Pancreatitis, Chronic - surgery
Postoperative Complications - etiology
Surgical Oncology
Tomography, X-Ray Computed
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Summary:A 72-year-old male patient presented to our department complaining of with upper abdominal pain and jaundice. He had a history of a side-to-side pancreaticojejunostomy performed 40 years previously for chronic pancreatitis. A diagnostic workup revealed a tumor 3 cm in size in the pancreatic head as the etiology of the jaundice. Subsequently, the patient was diagnosed with resectable pancreatic cancer. Following two cycles of neoadjuvant chemotherapy, an extended pancreatoduodenectomy was performed because of tumor invasion at the previous pancreaticojejunostomy site. Concurrent portal vein resection and reconstruction were performed. Pathological examination confirmed invasive ductal carcinoma (T2N1M0, Stage IIB). This case highlights the clinical challenges in pancreatic head carcinoma following a side-to-side pancreaticojejunostomy. Although pancreaticojejunostomy is believed to reduce the risk of pancreatic cancer in patients with chronic pancreatitis, clinicians should be aware that, even after this surgery, there is still a chance of developing pancreatic cancer during long-term follow-up.
ISSN:1865-7257
1865-7265
1865-7265
DOI:10.1007/s12328-024-01924-z