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Mami Ikeda, MD; Kiyoshi Hasegawa, MD, PhD; Nobuhisa Akamatsu, MD; Masami Minagawa, MD; Hiroshi Imamura, MD, PhD; Yasuhiko Sugawara, MD, PhD; Norihiro Kokudo, MD, PhD; Masatoshi Makuuchi, MD, PhD

Arch Surg. 2006;141:205-208.

Secondary pancreaticoduodenectomy was performed in 2 patients, 1 who had undergone proximal gastrectomy for a gastric carcinoma and 1 who had undergone subtotal esophagectomy with stomach tube reconstruction for an inferior thoracic esophageal carcinoma. To prevent ischemia and congestion of the remnant stomach, the inflow and outflow pathways to the stomach, such as the right gastroepiploic artery and vein, were preserved. In this article, we describe the preservation procedures and discuss the problems of the secondary abdominal surgical procedure.

Author Affiliations: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.