[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-367266-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-367266-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","successful-staged-surgery-for-advanced-esophageal-cancer-after-conversion-pancreatoduodenectomy-with-pancreaticogastrostomy","Successful staged surgery for advanced esophageal cancer after conversion pancreatoduodenectomy with pancreaticogastrostomy","","Complex surgery during initial cancer treatment can restrict surgical options when managing a secondary malignancy. Subtotal esophagectomy and pancreatoduodenectomy are among the most invasive and difficult gastroenterological procedures. Cases where subtotal esophagectomy is performed after pancreatoduodenectomy with pancreaticogastrostomy are extremely rare and technically challenging because of complex anatomical alterations. This work presents a two-staged approach after conversion pancreatoduodenectomy with pancreaticogastrostomy and reports favorable perioperative outcomes.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/successful-staged-surgery-for-advanced-esophageal-cancer-after-conversion-pancreatoduodenectomy-with-pancreaticogastrostomy/367266/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/successful-staged-surgery-for-advanced-esophageal-cancer-after-conversion-pancreatoduodenectomy-with-pancreaticogastrostomy/367266.png","ImageObject",300,407,{"name":42,"@type":43},"River Wang","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are staged procedures considered in patients needing surgery after pancreatoduodenectomy with pancreaticogastrostomy?","Question",{"text":63,"@type":64},"Staged surgery can reduce overall invasiveness and help manage complicated reconstruction challenges caused by altered anatomy. It also helps address limitations related to curability rates in complex settings.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What was the treatment course for the 60-year-old patient described in the case?",{"text":68,"@type":64},"After neoadjuvant chemotherapy, the team performed a two-staged operation: a first stage consisting of thoracoscopic subtotal esophagectomy with lymph-node dissection and esophagostomy, followed 56 days later by reconstruction using pedicle jejunum and microvascular anastomosis via the percutaneous route.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the postoperative and pathological outcomes reported?",{"text":72,"@type":64},"The patient was relieved without major complications, and the tumors were amenable to curative pathological resection.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},367266,1790220113,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":115,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","Clinical Journal of Gastroenterology (2025) 18:249–257  \n[https://doi.org/10.1007/s12328-025-02093-3](https://doi.org/10.1007/s12328-025-02093-3)  \nSuccessful staged surgery for advanced esophageal cancer after conversion pancreatoduodenectomy  \nwith pancreaticogastrostomy  \nYuta Sato1 · Yoshihiro Tanaka1 · Yuji Hatanaka1 · Takeshi Horaguchi1 · Masahiro Fukada1 · Itaru Yasufuku1 · Ryuichi Asai1 · Jesse Yu Tajima1 · Katsutoshi Murase1 · Nobuhisa Matsuhashi1  \nReceived: 26 September 2024 / Accepted: 31 December 2024 / Published online: 14 January 2025 © The Author(s) 2025  \nAbstract  \nBackground Complex surgery during initial cancer treatment can limit surgical options when planning management of a secondary malignancy. Subtotal esophagectomy and pancreatoduodenectomy are the most invasive and difficult procedures in gastroenterological surgery. Surgical cases in which subtotal esophagectomy was performed after pancreatoduodenectomy with pancreaticogastrostomy are extremely rare and challenging procedures due to the resulting complicated anatomical changes.  \nCase presentation A 60-year-old man with a history of conversion pancreatoduodenectomy with pancreaticogastrostomy for advanced pancreatic head cancer was diagnosed as having advanced thoracic esophageal squamous cell carcinoma. After neoadjuvant chemotherapy, we chose a two-staged surgery with thoracoscopic subtotal esophagectomy. Following percutaneous endoscopic gastrostomy, we performed subtotal esophagectomy, systematic lymph-node dissection, and esophagostomy as the first-stage operation. Fifty-six days later, we performed gastrointestinal reconstruction with pedicle jejunum and microvascular anastomosis by the percutaneous route as the second-stage operation. Postoperatively, the patient was relieved without major complications, and the tumors were amenable to curative pathologic resection.  \nConclusions The greatest advantages of staged surgery are to reduce surgical invasiveness and to circumvent the lower rate of curability. Our procedure reported here may be recommended as an option for staged resection and reconstruction inpatients with advanced esophageal cancer after pancreatoduodenectomy with pancreaticogastrostomy.  \nKeywords Esophageal cancer · Synchronous cancers · Staged surgery · Esophagectomy · Pancreatoduodenectomy  \nAbbreviations  \nSE  \nPD  \nSSPPD  \nmFOLFIRINOX  \nTS-1  \nDCF  \nPEG  \nDE  \nSubtotal esophagectomy Pancreatoduodenectomy  \nSubtotal stomach-preserving pancreatoduodenectomy  \nModified folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin  \nTegafur, gimeracil, and oteracil Docetaxel, cisplatin, and fluorouracil Percutaneous endoscopic gastrostomy Distal esophagectomy  \n* Yoshihiro Tanaka [yoshihirotana11@hotmail.com](yoshihirotana11@hotmail.com)  \n1 Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan  \nIntroduction  \nThe number of reports of multiple primary cancers is currently increasing because of advancements in diagnostic imaging and technology [1], and the incidence of these cancers in patients with esophageal cancer is reportedly 5–36%[2–4] . The most frequently occurring multiple primary cancers are head and neck, gastric, and lung cancer, which is characterized by field cancerization [5] . However, with a frequency of 0.1–5%, double primary cancer of the esophagus and pancreas is rarely reported [6, 7] . Subtotal esophagectomy (SE) and pancreatoduodenectomy (PD) are widely considered the most invasive and difficult surgical procedures in gastrointestinal surgery. When both procedures are performed in one patient, it is expected to be particularly difficult to reconstruct the gastrointestinal tract due to anatomical changes and preserve the circulation of the reconstructed organs. In such cases, staged surgery can  \nbe a beneficial option to spread out the invasiveness to the patient [8, 9] .  \nHerein, we report the suc","cbCaieOJqabNNgCN","https://ap.wps.com/l/cbCaieOJqabNNgCN","pdf",1714464,"English","# Abstract\n## Background\n## Case presentation\n## Conclusions\n# Introduction\n## Multiple primary cancers and surgical difficulty\n# Case report\n## Diagnosis and prior conversion surgery","[{\"question\":\"Why are staged procedures considered in patients needing surgery after pancreatoduodenectomy with pancreaticogastrostomy?\",\"answer\":\"Staged surgery can reduce overall invasiveness and help manage complicated reconstruction challenges caused by altered anatomy. It also helps address limitations related to curability rates in complex settings.\"},{\"question\":\"What was the treatment course for the 60-year-old patient described in the case?\",\"answer\":\"After neoadjuvant chemotherapy, the team performed a two-staged operation: a first stage consisting of thoracoscopic subtotal esophagectomy with lymph-node dissection and esophagostomy, followed 56 days later by reconstruction using pedicle jejunum and microvascular anastomosis via the percutaneous route.\"},{\"question\":\"What were the postoperative and pathological outcomes reported?\",\"answer\":\"The patient was relieved without major complications, and the tumors were amenable to curative pathological resection.\"}]","Successful staged surgery for advanced esophageal cancer after conversion pancreatoduodenectomy with pancreaticogastrostomy | PDF",1790169994,23]