Title: Total gastrectomy with pancreatosplenectomy and D3 lymph node dissection for advanced gastric cancer invading adjacent organs

Biography:

Merab Janelidze is a general surgeon at the Western Regional Center for Modern Medical Technologies, Georgian National University. His main interest is the abdominal surgical oncology and organ transplantation.

Abstract

We report 3 cases of emergency total gastrectomy associated with bleeding and hemorrhagic shock which was caused by gastric adenocarcinoma. A 55 year old woman and two men aged 57 and 61 respectively were admitted to our hospital because of massive hematemesis. There was a stomach cancer invasion in the spleen and the pancreas body in all three cases. The following emergency surgery was performed: total gastrectomy, esophagoenterostomy, pancreatico-jejunal anastomosis with invaginating method that was developed by us, hepaticoenterostomy, D3 lymph node dissection and Braun enteroenterostomy. Postoperative adjuvant chemotherapy is usually prescribed to improve the survival of patients. The follow-up period was two years. Survival benefit of surgery in advanced gastric cancer is still unclear. Subsequently, total gastrectomy with pancreatosplenectomy and D3 lymph node dissection remains the only curative therapy for patients with bleeding and hemorrhagic shock developed after gastric cancer with adjacent organs invasion.