[Pancreatoduodenectomy as Conversion Surgery for Advanced or Recurrent Gastric Cancer-A Report of Six Cases]

Pancreaticoduodenectomy(PD)has been increasingly performed as conversion surgery for advanced gastric cancer. We report 6 cases of gastric cancer in which PD was performed following chemotherapy. The reasons for requiring PD were pancreatic head invasion in 3 cases, common bile duct invasion in 1 case, and lymph node recurrence in the hepatic hilum after distal gastrectomy in 2 cases. Preoperative chemotherapy regimens included S-1+oxaliplatin in 3 cases, S-1+oxaliplatin+ trastuzumab in 1 case, capecitabine+oxaliplatin in 1 case, and S-1+cisplatin in 1 case. One patient died during hospitalization due to sepsis caused by postoperative cholangitis. A pancreatic fistula classified as Clavien-Dindo classification Grade Ⅲa occurred in 1 case. The 1-year and 2-year overall survival rates were 83.3% and 66.7%, respectively. The 1-year and 2- year recurrence-free survival rates were both 75.0%. Although the number of cases is limited, PD as conversion surgery for gastric cancer is considered an effective treatment option.