Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head: A case report

Table 1 Lymph node station

Station No.	Definition
1	Right paracardial nodes
3	Lesser curvature nodes
4sb	Left greater curvature nodes along the left gastroepiploic artery
4d	Right greater curvature nodes along the right gastroepiploic artery
5	Suprapyloric nodes
6	Infrapyloric nodes
7	Nodes at the root of the left gastric artery
8a	Anterosuperior LNs along the common hepatic artery
8p	Posterior LNs along the common hepatic artery
9	Nodes at the celiac artery
11p	Nodes along the proximal splenic artery
12a	Hepatoduodenal ligament LNs along the proper hepatic artery
12b	Hepatoduodenal ligament LNs along the bile duct
12p	Hepatoduodenal ligament LNs along the portal vein
14v	Nodes along the superior mesenteric vein
13a	Superior posterior pancreatoduodenal lymph nodes
13b	Inferior posterior pancreatoduodenal lymph nodes
17a	Superior anterior pancreatoduodenal lymph nodes
17b	Inferior anterior pancreatoduodenal lymph nodes

LNs: Lymph node.

Table 2 Timeline from the onset of symptoms to the completion of treatment

Time series	Symptoms and treatment details
5 mo ago	He had symptoms of abdominal pain, distension and weight loss (from 62 to 47 kg within 6 mo) and visited hospital
	Double elemental diet tube was inserted to administer enteral nutrition and drain food residue from the stomach
4 mo ago	Staging laparoscopy confirmed no liver metastasis, no dissemination, and negative lavage cytological results
	Laparoscopic ante-colic gastrojejunostomy and half-cut of the gastric body at the distal side of the anastomosis were performed
1-4 mo ago	SOX 1
	SOX + Trastuzumab 2-4
The date of surgery	Pancreaticoduodenectomy with D2 lymph node dissection for distal gastric cancer was done
	Adjuvant S1 1
2-8 mo after surgery	Adjuvant SOX 1-3
	CT shows no recurrence (7 mo after surgery)

CT: Computed tomography; SOX: S-1 plus oxaliplatin.