<Case reports>A case of early gastric cancer after pylorus-preserving pancreatoduodenectomy

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Pylorus-preserving pancreatoduodenectomy (PPPD) has become a standard operation instead of the conventional Whipple procedure because of its decreased morbidity and long-term nutritional consequences. We report a case of early gastric cancer that arose from the stomach after PPPD for chronic pancreatitis. The second operation, which consisted of laparotomy and wedge resection of the stomach lesion, was performed under perioperative guided endoscopy. Fortunately, the tumor was removed completely leaving the pancreatogastrostomy of the first operation untouched. This may be the first case in whom a second disease occurred in the preserved stomach after PPPD. It is conceivable that cases of this type will increase because of the long-term survival expected after PPPD. This case indicates that surgeons should pay more attention to gastric diseases in the course of pre- and post-operative examinations.
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