[A Case of Pancreatic Carcinoma and Short Bowel Syndrome with Long-Term Survival].

Abstract

A 75-year-old woman was admitted to our hospital with a complaint of jaundice and elevated liver enzyme levels. She was diagnosed with pancreatic head carcinoma after examination. She had undergone massive resection of the small intestine due to thrombosis of the superior mesenteric artery at 48 years of age, and the remaining ileum was approximately 70 cm in length. As the patient had no symptoms of short bowel syndrome, we deemed surgery to be feasible. We performed a subtotal stomach-preserving pancreaticoduodenectomy with gastropancreatic anastomosis to preserve the longest possible effective small intestine length. Although surgical site infection was observed postoperatively, parenteral nutrition was discontinued on the 24th postoperative day, and the patient was discharged on the 54th postoperative day. The final diagnosis was pancreatic head carcinoma, pT3N0M0, pStage ⅡA. At 54 months postoperatively, the patient is alive, has no recurrence, and is in a good nutritional condition. Although patients are prone to nutritional disorders after massive resection of the small intestine or pancreaticoduodenectomy, the nutritional status should be maintained using a surgical technique that can leave a long effective residual small intestine length.