# Longitudinal Pancreatojejunostomy for Pancreaticodigestive Reconstruction in the Resection of Pancreatic Head Malignancy with Chronic Pancreatitis: A Case Report

## TL;DR

A patient with pancreatic cancer and chronic pancreatitis underwent a specialized surgery to preserve pancreatic function and avoid postoperative complications.

## Contribution

This case report presents the use of longitudinal pancreatojejunostomy in pancreatic head malignancy with pancreatolithiasis.

## Key findings

- SSPPD and LPJ were successfully used to preserve pancreatic function in a patient with IPMC and PL.
- The patient had no postoperative complications or tumor recurrence for 8 months after surgery.

## Abstract

With progress in pancreatic surgery, a preservation of residual organ function has become more important. Pancreatic malignancies are occasionally accompanied by chronic pancreatitis (CP) and pancreatolithiasis (PL). Longitudinal pancreatojejunostomy (LPJ) is reportedly a useful method of surgical management in cases of CP with PL. We describe a patient with pancreatic head intraductal papillary mucinous carcinoma (IPMC) concomitant with PL, who underwent subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) and LPJ for reconstruction.

A man in his 70s was referred to our hospital with a pancreatic head tumor. He had been treated for CP, diabetes mellitus, and chronic kidney disease. Imaging revealed a cystic pancreatic head tumor with a solid component that was histologically confirmed as IPMC. In addition, multiple calcifications suggestive of PL were observed in the pancreatic body and tail. SSPPD and LPJ were performed to excise the PL as much as possible and preserve the residual pancreatic function. The postoperative course was uneventful, and no abdominal symptoms or tumor recurrences were observed for approximately 8 months after surgery.

This patient with IPMC with residual pancreatic PL was treated with SSPPD and LPJ to maximize the residual pancreatic function and reduce the occurrence of postoperative pancreatitis.