Laparoscopic total gastrectomy for concurrent gastric cancer and complete agenesis of the dorsal pancreas.

Abstract

We present an unusual case of laparoscopic total gastrectomy with lymph node dissection in a 56-year-old woman with gastric cancer and agenesis of the dorsal pancreas (ADP). Esophagogastroduodenoscopy revealed erosive lesions with thickened gastric folds; biopsy specimens revealed a poorly differentiated adenocarcinoma. Abdominal contrast-enhanced computed tomography showed a thickened wall of the gastric body; the distal pancreas was not visualized. Under the clinical diagnosis of gastric cancer with ADP, the patient underwent laparoscopic total gastrectomy with standard lymphadenectomy. The absence of a pancreatic neck, body, and tail was confirmed; lymph nodes along the splenic artery were dissected. Pathological analysis demonstrated a poorly differentiated adenocarcinoma invading the serosa, with five lymph node metastases. The postoperative course was unremarkable; postoperative adjuvant chemotherapy was performed using S-1 plus oxaliplatin. No symptom recurrence was observed at the 6-month follow-up. Laparoscopic surgery, with careful preoperative anatomic evaluation, can be considered for concurrent gastric cancer and ADP.

• Authors: Tsutomu Namikawa, Masato Utsunomiya, Keiichiro Yokota, Yasuhiro Kawanishi, Masaya Munekage, Sunao Uemura, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki
• Journal: Asian journal of endoscopic surgery (Asian J Endosc Surg) Vol. 16 Issue 2 Pg. 266-270 (Apr 2023) ISSN: 1758-5910 [Electronic] Japan
• PMID: 36148900 (Publication Type: Case Reports)
• Copyright: © 2022 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.

Topics

• Female
• Humans
• Middle Aged
• Stomach Neoplasms (complications, surgery, pathology)
• Laparoscopy (methods)
• Lymph Node Excision (methods)
• Gastrectomy (methods)
• Adenocarcinoma (surgery, secondary)