Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2022; 10(16): 5324-5330
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5324
Laparoscopic duodenojejunostomy for malignant stenosis as a part of multimodal therapy: A case report
Teppei Murakami, Yugo Matsui
Teppei Murakami, Yugo Matsui, Department of Surgery, Kobe City Hospital Organization Kobe City Center West Hospital, Kobe 653-0013, Hyogo, Japan
Author contributions: Murakami T wrote the manuscript; Matsui RY made the manuscript revision; All authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Teppei Murakami, MD, PhD, Doctor, Department of Surgery, Kobe City Hospital Organization Kobe City Center West Hospital, 4-2 Ichibancho Nagata-ku, Kobe 653-0013, Hyogo, Japan. manetorix@gmail.com
Received: June 22, 2021
Peer-review started: June 22, 2021
First decision: August 19, 2021
Revised: August 28, 2021
Accepted: April 2, 2022
Article in press: April 2, 2022
Published online: June 6, 2022
Abstract
BACKGROUND

Laparoscopic duodenojejunostomy (LDJ) has become the standard surgical procedure for superior mesenteric artery syndrome due to its sufficient outcome in terms of safety and symptom relief. However, there are only a few reports about LDJ for malignant stenosis and its indication remains uncertain.

CASE SUMMARY

A 77-year-old woman with a history of pancreatic cancer (PC) treated with distal pancreatectomy with en bloc resection of the transverse colon 7 mo ago was admitted for recurrent vomiting. Imaging upon admission revealed marked distention of the duodenum and a tumor around the duodenojejunal flexure. She was diagnosed with malignant stenosis caused by local recurrence of PC. LDJ was performed with an uneventful postoperative course, followed by chemotherapy which gave her 10 mo overall survival.

CONCLUSION

We think that LDJ is a valuable method for unresectable malignant stenosis around the duodenojejunal flexure as a part of multimodal therapy.

Keywords: Duodenojejunostomy, Laparoscopic surgery, Malignant stenosis, Pancreatic cancer, Multimodal therapy

Core Tip: There are many reports on laparoscopic duodenojejunostomy (LDJ) for superior mesenteric artery syndrome, but rarely for malignant stenosis. In general, prognosis of patients with recurrent cancer is poor; however, development of new chemotherapeutic agents and new combination therapy improve their overall survival. Obstruction due to malignancy is often an obstacle for chemotherapy, and a safe and minimally invasive method would help enable a rapid induction. We think LDJ is a valuable method for patients with unresectable malignant stenosis around the duodenojejunal flexure.