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The journal «ONCOSURGERY» 2013, Vol.5, No 1

Gastrectomy in combination with pancreatoduodenal resection for gastric cancer

Kit OI, Kasatkin VF, Maksimov AY, Trifanov VS

Rostov Research Oncological Institute, Department of Thoracoabdominal Surgery, Rostov on Don, Russia
Contact: Kit Oleg Ivanovich, e-mail:

Specifics of gastrectomy in combination with pancreatoduodenal resection in patients with locally advanced gastric tumors that invade in head of the pancreas are described in the article.

Materials and methods. Retrospective analysis of 22 patients who underwent gastrectomy in combination with pancreatoduodenal resection at the period from 1983 to 2010 in the Department of Thoracoabdominal Surgery of Rostov Research Oncological Institute.

Pancreatoduodenal resection (PDR) was performed for gastric, colonic cancer and renal, retroperitoneal tumors that had invasion in pancreas or/and duodenum in 44 (9,7%), 27 (5,9%), 7 (1,5%) and 5 (1,1%) cases respectively. Out of 44 patients, who had pancreatoduodenal resection for gastric cancer, the surgery was combined with gastrectomy in 22 cases and with distal subtotal gastric resection in 22 cases. In patient with gastric cancer, adenocarcinoma was found in 36 cases, 4 patients revealed undifferentiated and 4 – signet ring cell carcinoma.

There were 28 men and 16 women, the average age of the patients was 57.4 years (range 32 to 75 years).

Results. Patient groups who have indications for gastrectomy combined with pancreatoduodenal resection was determined. Number of early postoperative complications in the study group of patients was 73.3%, 2 patients died.

Delayed reconstruction surgery was performed in 5 cases of the 20 discharged patients, no complications were observed.

Conclusion. Pancreatoduodenal resection in combination with gastrectomy in combined surgery for gastric cancer, in case of invasion in pancreas and / or duodenum, increases radicalism of the surgery and provides a long-term survival of patients in this very difficult group in the first 3 years.

At the present stage of development of the PDR surgery in combination with gastrectomy performed by an experienced surgeon-oncologist, with adequate anesthesia and postoperative medical support is justified for locally advanced tumor without metastases in regional lymph nodes.

KEY WORDS: gastric cancer, gastrectomy, pancreatoduodenal resection.


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