Pancreaticoduodenectomy for primary locally advanced adenocarcinoma of duodenum
Description: EXCLUSIVE SURGICAL CASE. Primary carcinoma of duodenum is very rare. This clinical case seems to be exclusive. We have performed surgery to a young man for the tumor of distal descendens and horizontal parts of duodenum. Tumor extended from Vater's papilla to Treitz ligament with invasion of mesentericum, jejunum vessels, mesocolon, paraaortal fat. Tumor was located beetwen mesenteric vessels and aortocaval space. Invasion was detected in paraaortal fatty tissue and right perinephrium with partial compression of abdominal aorta and vena cava inferior. Superior mesenteric artery was surrounded by the tumor mass.
He has 2,5 year anamnesis of disease and was recognized as incurable because of unresectable tumor in November 2010. Before he applied our clinic he had two palliative surgeries -- gastrojejunostomy (2010) and cholecystostomy (2012).
He came in our clinic in April 2013 . His quality of life was very poor because of permanent abdominal pain and dyspepsia, weight loss and anemia because of periodic melena. We investigated him in detail. No dissemination of disease was found. Only locally advanced tumor of duodenum was diagnosed. Biopsy was performed during duodenoscopy and morphological verification before surgery was carcinoma .
After the preparation we performed R0 pancreatoduodenectomy( Whipple resection) . Patient has left our clinic without complications in 14 days after the surgery. Morphological conclusion is solid adenocarcinoma. No metastatic lymphnodes were detected. Primary localization of the tumor -- horizontal part of duodenum.
Shared By : ilyagotsadze
Posted on : 01/09/14
Added : 4 years ago