© Borgis - New Medicine 1/2014, s. 26-28
Prophylactic gastroenterostomy in patient with unresectable pancreatic head cancer – case report
1Faculty of Medicine, Department of Oncology, University of Warmia and Mazury, Olsztyn, Poland
Head of Department of Oncology: prof. Sergiusz Nawrocki, MD, PhD
2Department of Surgical Oncology, Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre, Olsztyn, Poland
Head of Department of Surgical Oncology: Andrzej Lachowski, MD
Optimal treatment patients with unresectable pancreatic head cancer is still a matter of debate for several reasons. The number of patients with unresectable pancreatic head cancer is increasing and their optimal treatment is a growing economic problem for health care. In this article the author presented a case of a man who was admitted to the hospital because of unresectable pancreatic head cancer. The patient underwent prophylactic gastroenterostomy and in the fifth day after surgery was discharged home.
Optimal treatment patients with unresectable pancreatic head cancer is still a matter of debate for several reasons (1, 2). First reason: it is difficult to predict the number of patients who will suffer from duodenal obstruction, and second reason is possible complications after gastroenterostomy (1-5). The number of patients with unresectable pancreatic head cancer is increasing and their optimal treatment is a growing economic problem for health care (4-7).
A 58-year-old man, Caucasian race, was admitted to the Department of Surgical Oncology because of pancreatic head tumor. The patient did not eat the food for last 10 days, drank only water. Within a month, he lost about 10 kg. He had history of alcohol consumption about 80-120 gram/day for 10 years and he was heavy smoker – 15 cigarette/day for 20 years. In the past the patient have had pancreatitis twice and did not claim any additional diseases.
Blood examination of the patient showed raised results of amylase and lipase results and low levels of albumin and total protein. Other laboratory tests were normal.
On physical examination, in the epigastrium area a tumor was palpable. CT examination showed a pathological mesogastric lumpy mass in the region of the descending duodenum and the head of the pancreas, the size of tumor was approximately 50 x 58 x 42 mm, with cystic spaces and small, individual calcifications. The rest of the pancreas was not enlarged, even atrophic, but with a prominent extended to approximately 6 mm pancreatic duct in the stem of the pancreas and less clearly in its tail (fig. 1). A tumor of the pancreatic head infiltrated and compressed the duodenum causing obstruction of the upper gastrointestinal tract (fig. 2).
Fig. 1. CT image showed the large pancreatic tumor (diameter 50 x 58 x 42 mm) infiltrating and compression of the duodenum.
Fig. 2. CT image showed the residual contents of the stomach caused by obstruction of the duodenum. Duodenal obstruction was caused by infiltration and compression of the duodenum by the pancreatic tumor.
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zaakceptowano do druku: 2014-02-19
Adres do korespondencji:
General Surgery Consultant Faculty of Medicine, Department of Surgical Oncology University of Warmia and Mazury, Olsztyn, Poland
37 al. Wojska Polskiego St., 10-228 Olsztyn
tel.: +48 505-818-126
e-mail: firstname.lastname@example.orgNew Medicine 1/2014
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