En bloc Pancreaticodudenectomy with Colectomy for Locally Advanced Right Sided Colon Cancer

  • Ramesh Singh Bhandari Surgical Gastroenterology Units, Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
  • Paleswan Joshi Lakhey Surgical Gastroenterology Units, Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
  • Parsu Ram Mishra Surgical Gastroenterology Units, Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Keywords: colectomy; locally advanced; pancreaticoduodenectomy.

Abstract

A 57 year old male presented to our outpatient clinic with history of on and off melena, weight loss and decreasing appetite for 10 months duration and a noticeable mass on the right upper quadrant. Abdominal examination revealed an intra-abdominal lump in right upper quadrant which was subsequently evaluated by colonoscopy, which revealed an ulcero-proliferative growth in the hepatic flexure and the biopsy from it confirmed well-differentiated adenocarcinoma. Contrast enhanced computed tomography demonstrated hepatic flexure mass with possible invasion into adjacent duodenum without features of advanced disease. After completion of necessary preoperative assessment and investigations, patient was explored with curative intent and underwent extended right hemicolectomy with en bloc pancreaticodudenectomy. Patient was discharged on 10th postoperative day and at 14 months follows up; he was doing well without any evidence of recurrence.

Keywords: colectomy; locally advanced; pancreaticoduodenectomy.

References

1. Heslov SF, Frost DB. Extended resection for primary
colorectal carcinoma involving adjacent organs or structures.
Cancer1988;62:1637-40.
2. Lianwen Y, Jianping Z, Guoshun S, Dongcai L, Jiapeng Z.
Surgical treatment for right colon cancer directly invading
the duodenum. The American surgeon 2009;75:385-88.
3. Song XM, Wang L, Zhan WH, et al. Right Hemicolectomy
combined with pancreaticodudenectomy for the treatment
of colon carcinoma invading the duodenum or pancreas.
Chin Med J 2006;119:194-7.
4. Staniunas RJ, Schoetz: Extended resection for carcinoma of
the colon and rectum. Surg Clin North Am 1993;73:117-129.
5. Colon and Rectal cancer staging. American Joint Committee
on Colon Cancer. 7th edition.
6. Lopez MJ, Monafo WW. Role of extended resection in the
initial treatment of locally advanced colorectal carcinoma.
Surgery 1993;113:365- 72.
7. Croner R, Merkel S, Papadopoulos T, Schellerer V,
Hohenberger W, Goehl J. Multivisceral resection for colon
carcinoma. Dis Colon Rectum 2009;52:1381-6.
8. Berrospi F, Celis J, Ruiz E, Payet E. En bloc pancreaticoduodenectomy
for right colon cancer invading adjacent organs.
J Surg Oncol 2002;79:194-8.
9. Grossmann I, Klaase JM, Avenarius JK, de Hingh IH,
Mastboom WJ, Wiggers T. The strengths and limitations
of routine staging before treatment with abdominal CT in
colorectal cancer. BMC Cancer 2011;11:433.
10. Edge SB, Schmieg RE Jr, Rosenlof LK, Wilhelm MC. Pancreas
cancer resection outcome in American university centres in
1989- 1990. Cancer 1993:71:3502-8.

Cameron JL, Riall TS, Coleman J, Belcher KA. One
thousand consecutive pancreaticodudenctomies. Ann Surg
2006;244:10-5.
12. Gordon TA, Burleyson GP, Tielsch JM, Cameron JL. The
effects of regionalization on cost and outcome for one general
high risk surgical procedure. Ann Surg 1995;221:43-9.
13. Landmann RG, Weiser MR. Surgical management of locally
advanced and locally recurrent colon cancer. Clin Colon
Rectal Surg 2005;18:182-9.
14. Koea JB, Conlon K, Paty PB, Guillem JG, Cohen AM.
Pancreatic or duodenal resection or both for advanced
carcinoma of the right colon: is it justified? Dis Colon Rectum
2000;43:460-5.
15. Curley SA, Evans DB, Ames FC: Resection for cure of
carcinoma of the colon directly invading the duodenum of
pancreatic head. J Am Coll Surg 1994;179:587-592.
16. Saiura A, Yamamoto J, Ueno M, Koga R, Seki M, Kokudo N.
Long term survival in patients with colon cancer after en bloc
pancreaticodudenectomy and colectomy. Dis Colon Rectum
2008;51:460-5.
17. Cirocchi R, Partelli S, Castellani E, Renzi C, Parisi A, Noya
G, Falconi M. Right hemicolectomy plus pancreaticoduodenectomy
vs partial duodenectomy in treatment of locally
advanced right colon cancer invading pancreas and/or only
duodenum. Surgical Oncology 2014;23:92-98.
18. Lianwen Y, Jianping Z, Guoshun S, Dongcai L, Jiapeng
Z. Pedicled Ileal flap for duodenal defect after right
hemicolectomy. Hepatogastroenterology 2010;57:493-6.
Published
2015-12-31
How to Cite
Bhandari, R., Lakhey, P., & Mishra, P. (2015). En bloc Pancreaticodudenectomy with Colectomy for Locally Advanced Right Sided Colon Cancer. Journal of Nepal Medical Association, 53(200), 301-303. https://doi.org/10.31729/jnma.2752
Section
Case Reports