RESUMO
A 69-year-old man, who had undergone pylorus-preserving pancreaticoduodenectomy (PD) (Imanaga procedure) for duodenum papilla cancer 13 years prior, had a history of repeated hospitalization due to cholangitis since the third year after surgery and liver abscess at the 10th year after surgery. Gastrointestinal series indicated no stenosis after the cholangiojejunostomy. However, reflux of contrast media into the bile duct and persistence of food residues were observed. We considered the cholangitis to be caused by reflux and persistence of food residues into the bile duct. So, we performed the tract conversion surgery, Imanaga procedure to Child method. The postoperative course was good even after re-initiating dietary intake. He was discharged on the 19th day after surgery. He has not experienced recurrent cholangitis for 18 months. For patients with post-PD recurrent cholangitis caused by reflux of food residues like ours, surgical treatment should be considered because tract conversion may be an effective solution.
RESUMO
We report the case of a 64-year-old man who underwent resection on two occasions for recurrent renal cell carcinoma. He first underwent right nephrectomy for renal cell carcinoma, and 10 years later, he underwent pylorus-preserving pancreaticoduodenectomy for pancreatic metastasis. Microscopic extracapsular invasion without lymph node metastasis was observed at that time. Twelve years after the first surgery, he was diagnosed with stomach metastasis. Clinically, metastases to other organs was not observed, and endoscopic ultrasonography revealed no changes in the submucosal layer; endoscopic submucosal dissection was subsequently performed. Pathologically, the tumor was found to be localized in the mucosal layer. There has been no occurrence of metastases for 2 years and 6 months since the last surgery.
Assuntos
Carcinoma de Células Renais/secundário , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Nefrectomia , Neoplasias Pancreáticas/secundário , Neoplasias Pancreáticas/cirurgia , Neoplasias Gástricas/secundário , Neoplasias Gástricas/cirurgia , Carcinoma de Células Renais/patologia , Gastrectomia/métodos , Mucosa Gástrica/cirurgia , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Tratamentos com Preservação do Órgão , Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia/métodos , Piloro , Neoplasias Gástricas/patologia , Fatores de Tempo , Resultado do TratamentoRESUMO
A 64-year-old man underwent resection of a mesenteric desmoid tumor in May 2006. He presented with a chief complaint of loss of appetite at a local hospital in July 2011. A huge abdominal tumor was detected on computed tomography, and he was referred to our hospital. We suspected recurrence of the desmoid tumor 5 years and 2 months after the first surgery and performed re-resection, revealing two tumors, measuring 32×29×10cm and 7.0×6.0×4.5cm, respectively. Histopathologic examination yielded a diagnosis of mesenteric desmoid tumor recurrence. Four months after re-resection, the patient is alive without recurrence.