Totally Laparoscopic Distal Gastrectomy in Post Liver Transplant Patient

Abstract

The risk of malignancy after transplantation is higher than that of general population. Laparoscopic surgery has become a standard treatment of gastric cancer. However, there are no case reports evaluating totally laparoscopic gastrectomy in patients with previous liver transplantation. Herein we report our experience with a liver transplant recipient who underwent totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. A 63 year-old man underwent orthotopic liver transplantation (OLT) for cryptogenic liver cirrhosis. 8 years later, gastric cancer was diagnosed during the follow-up. Endoscopic submucosal dissection was performed and additional surgical resection was needed. TLDG and D1+ lymph node dissection was performed, and the patient was discharged on the 8th post-operative day without any complications. To the best of our knowledge, this is the first case of de novo gastric cancer treated with TLDG after OLT. This suggests that TLDG is a feasible for patients after OLT.

De novo gastric cancer after liver transplantation: A review of the Asian experience

“…Along with the recent preference for laparoscopic gastrectomy, it has been performed even in the LT recipients with gastric cancer. The world-first case of totally laparoscopic distal gastrectomy for gastric cancer was performed in a 63-year-old man who underwent LT for cryptogenic liver cirrhosis [16]. Eight years later, gastric cancer was diagnosed during the follow-up.…”

Clinical outcomes of gastric cancer surgery after liver transplantation

“…Recent clinical trials have demonstrated the safety and feasibility of laparoscopic surgery for primary gastric cancer [ 6 ]. However, reports on the laparoscopic approach for de novo gastric cancer after LT are limited [ 7 8 ]. Therefore, we aimed to evaluate the surgical safety and oncological outcomes of gastric cancer surgery including open and laparoscopic approaches.…”