Laparoscopy-assisted distal gastrectomy combined with laparoscopic spleen-preserving distal pancreatectomy for the treatment of early gastric cancer with pancreatic cystic neoplasm.

The use of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) and laparoscopic distal pancreatectomy (LDP) for lesions of benign or borderline malignancy have gained worldwide acceptance because they are viewed as safe and feasible. A 59-year-old man was diagnosed with EGC and intraductal papillary mucinous neoplasm (IPMN) simultaneously during cancer screening. LDP was performed prior to LADG due to the possibility of splenectomy. After completing LDP, LADG was performed in the usual manner. LADG combined with spleen-preserving LDP was performed safely. The operating time was 561 minutes, and there was no intraoperative complication. The patient was discharged on postoperative 10 without any complications. No recurrence or distant metastasis occurred during the subsequent 40 months. LADG combined with spleen-preserving LDP for EGC and IPMN was found to be feasible and less invasive than open surgery.

[1]  S. Lange Branch duct intraductal papillary mucinous neoplasms in a retrospective series of 190 patients , 2009 .

[2]  B. Eom,et al.  Synchronous and metachronous cancers in patients with gastric cancer , 2008, Journal of surgical oncology.

[3]  Song-Cheol Kim,et al.  Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution , 2008, Surgical Endoscopy.

[4]  I. Choi,et al.  Surgical Complications and the Risk Factors of Laparoscopy-Assisted Distal Gastrectomy in Early Gastric Cancer , 2008, Annals of Surgical Oncology.

[5]  Michelle A. Anderson,et al.  Risk of Malignancy in Resected Cystic Tumors of the Pancreas ≤3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report , 2008, Journal of Gastrointestinal Surgery.

[6]  Yoo-Seok Yoon,et al.  Clinical outcomes compared between laparoscopic and open distal pancreatectomy , 2008, Surgical Endoscopy.

[7]  Norio Shiraishi,et al.  A Multicenter Study on Oncologic Outcome of Laparoscopic Gastrectomy for Early Cancer in Japan , 2007, Annals of surgery.

[8]  S. Choi,et al.  Treatment Guidelines for Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas: When Can We Operate or Observe? , 2007, Annals of Surgical Oncology.

[9]  H. Shimada,et al.  Spleen-Preserving Distal Pancreatectomy Combined with Distal Gastrectomy for Distal Pancreatic Lesion and Gastric Cancer: Report of a Case , 2007, Surgery Today.

[10]  I. Choi,et al.  Gastric cancer patients at high-risk of having synchronous cancer. , 2006, World journal of gastroenterology.

[11]  S. Chari,et al.  International Consensus Guidelines for Management of Intraductal Papillary Mucinous Neoplasms and Mucinous Cystic Neoplasms of the Pancreas , 2006, Pancreatology.

[12]  Y. Atomi,et al.  Laparoscopic pancreatic surgery. , 2005, Journal of hepato-biliary-pancreatic surgery.

[13]  J. Neoptolemos,et al.  Postoperative pancreatic fistula: an international study group (ISGPF) definition. , 2005, Surgery.

[14]  Cristiano G S Huscher,et al.  Laparoscopic Versus Open Subtotal Gastrectomy for Distal Gastric Cancer: Five-Year Results of a Randomized Prospective Trial , 2005, Annals of surgery.

[15]  H. Kaneko,et al.  Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. , 2004, Journal of hepato-biliary-pancreatic surgery.

[16]  Y. Shimada JGCA (The Japan Gastric Cancer Association). Gastric cancer treatment guidelines. , 2004, Japanese journal of clinical oncology.

[17]  A. Warshaw Conservation of the spleen with distal pancreatectomy. , 1988, Archives of surgery.