[A Case of Distal Pancreatectomy with Preserving the Remnant Stomach Post Distal Gastrectomy]

It is unclear whether the remnant stomach can be safely preserved, performing distal pancreatectomy in patients with a prior distal gastrectomy. A 74-year-old man was followed up after robotic distal gastrectomy with D2 lymphadenectomy and Roux-en-Y reconstruction for gastric cancer. Contrast-enhanced computed tomography revealed a tumor of the pancreatic tail. Subsequently, the tumor was diagnosed as a resectable pancreatic adenocarcinoma. After neoadjuvant chemotherapy, we performed laparoscopic distal pancreatectomy with splenectomy. Blood flow in the remnant stomach was confirmed by preoperative angiography using splenic artery occlusion test and intraoperative indocyanine green fluorescence imaging. We safely preserved the remnant stomach and the postoperative course was uneventful.