Pancreaticoduodenectomy with a double Roux-en-Y reconstruction performed after Billroth II gastric resection

Zijah Rifatbegovic ； Emir Ahmetasevic ； Amra Mestric ； Zlatan Mehmedovic ； Majda Mehmedovic

《Edorium Journal of Gastrointestinal Surgery》 3期 (2016/12) Pp. 1-4

https://doi.org/10.5348/G02-2016-3-CR-1

摘要

Introduction: In the presence of the pancreatic head malignancy the resection is indicated in the absence of proven metastases and if the tumor is of such size that the major blood vessels are not implicated. When the pancreaticoduodenectomy is performed the double Roux-en-Y digestive tract reconstruction can be addressed to decrease the liquid flow and pressure in the duodenum and reduce the risks of traction, twisting and angularity of the jejunal loop associated with common reconstruction methods. Case Report: A 68-year-old man was admitted with abdominal pain, vomiting, jaundice, and weight loss. Before admission to the Surgery clinic he had underwent a diagnostic evaluation where computed tomography (CT) scanning revealed pancreatic head mass. The patient had gastric resection due to benign gastric ulcer disease 23 years prior. We performed a pancreaticoduodenectomy and used an efferent jejunal loop from the gastrojejunal anastomosis to perform a double Roux-en-Y anastomosis. Conclusion: We showed that double Roux-en-Y reconstruction after the pancreaticoduodenectomy can be successful way for reconstruction in case that gastric resection was performed prior.

關鍵字

Pancreaticoduodenectomy ； Double Roux-en-Y reconstruction ； Gastric resection