Japanese

A case of early-stage gastric cancer combined with portal annular pancreas treated by laparoscopic distal gastrectomy Nagato SATO 1,2 , Kazuyuki HIROSE 1,2 , Dai MIYAZAKI 1,2 , Naoya FUKUDA 1 , Yasuaki IIMURA 1 , Satoshi HIRANO 2 1Department of Surgery, Kushiro City General Hospital 2Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine Keyword: 門脈輪状膵 , 胃癌 , 腹腔鏡 pp.355-359
Published Date 2020/9/15
DOI https://doi.org/10.11477/mf.4426200830
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 We report a case of early-stage gastric cancer combined with portal annular pancreas (PAP) treated by laparoscopic distal gastrectomy. A 62-year-old woman with a diagnosis of early-stage gastric cancer in the lower stomach underwent surgery. During the suprapancreatic nodal dissection, a large amount of pancreatic parenchyma was found in the cranial side of the common hepatic artery. We did not recognize the presence of PAP before surgery; thus, we misunderstood the pancreatic parenchyma as lymph node #8a. During the dissection of node #8a, the tissue was recognized not as the node but as the pancreatic parenchyma based on its differences in color. Laparoscopic distal gastrectomy was performed without any injuries to the pancreas. Retrospectively, computed tomography showed that the portal vein was completely surrounded by pancreatic parenchyma, which was a finding of PAP. Although there have been no reports of surgery performed for gastric cancer with PAP, the presence of PAP confers a risk of pancreatic injury during suprapancreatic nodal dissection.


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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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