A CASE OF ADVANCED PRIMARY DUODENAL BULB CANCER-A DISCUSSION OF SURGICAL PROCEDURES IN LYMPH NODE METASTASIS-:A DISCUSSION OF SURGICAL PROCEDURES IN LYMPH NODE METASTASIS
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We report a patient with advanced primary duodenal bulb cancer diagnosed incidentally prior to gallstones surgery. A 56-year-old woman seen to treat cholecystolithiasis with cholecystitis was found in preoperative screening with upper gastrointestinal endoscopy to have duodenal bulb cancer, necessitating distal gastrectomy with regional lymph node dissection, Billroth II reconstruction, and cholecystectomy. Macroscopically, the 3.2×2.5 cm tumor appeared to be Borrmann 1 and was located in the upper wall of the duodenal bulb. The histological diagnosis was poorly differentiated adenocarcinoma without invasion of the serosa or lymph node involvement.Duodenal cancer generally requires pancreaticoduodenectomy, but other surgical procedures may be considered in duodenal bulb carcinoma without serosal invasion. We discuss optimal resection for duodenal bulb cancer in lymph node metastasis based on areview of the literature.
- 日本臨床外科学会の論文
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