Pancreaticoduodenectomy for pancreatic cancer after laparoscopic Roux-en-Y gastric bypass

A Novel Reconstruction Technique During Pancreaticoduodenectomy After Roux-En-Y Gastric Bypass: How I do It

“…The gastric remnant in one case could not be technically resected due to dense adhesions 17. This was also the case in other reports where left upper quadrant adhesions precluded a safe resection of the gastric remnant due to the risk of injury to the functional gastric pouch and the previously created gastrojejunostomy 18, 19. A separate Roux limb has been proposed to drain the gastric remnant when it could not be resected.…”

“…Finally, an additional benefit to this form of reconstruction is that the gastric remnant is defunctionalized and not in continuity with the gastrointestinal tract. The alternative methods of drainage of the gastric remnant suggested in the literature used an additional jejunal limb (to the retained stomach remnant) for this purpose, resulting in a potentially ulcerogenic anatomy, especially when a retained antrum is a part of the gastric remnant 19. In contrast, drainage of the gastric remnant through the same jejunal limb used for biliary drainage, combined with a PG, will have a protective effect against the formation of a marginal ulcer.…”

Pancreatoduodenectomy after Roux-en-Y gastric bypass: technical considerations and outcomes

“…Articles cited within the initially identified batch were also screened and a total of seven cases and series were identified for inclusion. [5][6][7][8][9][10][11]…”

“…Literature review A literature search revealed seven publications describing a total of 14 patients. [5][6][7][8][9][10][11] The preoperative workup, operative management of the remnant stomach and reconstruction, and postoperative complications are summarized in Table 4. The indications for surgery were variable and included both benign and malignant processes.…”

Effect of bariatric surgery on future general surgical procedures

“…Rutkoski et al .,[30] have reported a case of pancreaticoduodenectomy for a 2 cm mass in the pancreatic head, presenting 3.5 years after Roux-en Y gastric bypass [Figure 3]. Kuper et al .,[31] have reported a case of pancreatic cancer following sleeve gastrectomy that was treated with Pylorus preserving pancreaticoduodenectomy for a pT3 tumor, which recurred nine months post-operatively.…”