*Konrad Wroński1, 2, Przemysław Stefaniak2
New type of prophylactic gastroenterostomy in patient with unresectable pancreatic head carcinoma
1Department of Oncology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
Head of Department: 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: Andrzej Lachowski, MD
Summary
Pancreatic cancer is a important public health problem all over the world. Up to 80% patients with carcinoma of head of the pancreas are unresectable because of local vascular invasion or distant metastasis. Optimal treatment of such patients is surgical bypass. The number of patients with unresectable pancreatic head cancers is increasing and their optimal treatment is a big economic problem for health care. Traditional prophylactic gastroenterostomy has many complications in postoperative period. Because of complications period of stay in hospital extended and generates additional costs. In this article the authors presented a case of a Caucasian woman who was admitted to the hospital because of unresectable pancreatic head cancer. The patient underwent new type of prophylactic gastroenterostomy and in the sixth day after surgery was discharged home. The authors invented this new type of anastomosis and applied it successfully in several patients with unresectable carcinoma of head of the pancreas.

INTRODUCTION
Pancreatic cancer is a important public health problem all over the world. Up to 80% patients with carcinoma of head of the pancreas are unresectable because of local vascular invasion or distant metastasis (1). Optimal treatment of such patients is surgical bypass. The number of patients with unresectable pancreatic head cancers is increasing and their optimal treatment is a big economic problem for health care. Traditional prophylactic gastroenterostomy has many complications in postoperative period. Because of complications period of stay in hospital extended and generates additional costs. In this article the authors presented a case of a Caucasian woman who was admitted to the hospital because of unresectable pancreatic head cancer. The patient underwent new type of prophylactic gastroenterostomy and in the sixth day after surgery was discharged home. The authors invented this new type of anastomosis and applied it successfully in several patients with unresectable carcinoma of head of the pancreas.
CASE REPORT
A 71-year-old woman, Caucasian race, with pancreatic head tumor, was admitted to the Department of Surgical Oncology because of obstructive symptoms of upper gastrointestinal tract. The patient did not eat the food for last 2 weeks, drank only water. Within a month, she lost about 20 kg. She was treated chronically with hypertension and ischemic heart disease.
Blood examination of the patient showed low levels of hemoglobin, erythrocytes, albumin and total protein. Other laboratory tests were normal.
On physical examination, in the epigastrium area there was palpable a tumor. CT examination showed a pathological mesogastric lumpy mass in the region of the descending duodenum and the head of the pancreas, which the size was approximately 75 x 68 x 45 mm. The rest of the pancreas was not enlarged. On CT scan a tumor of the pancreas head infiltrated and compressed the duodenum causing obstruction of the upper gastrointestinal tract.
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Piśmiennictwo
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