Colo-pancreaticoduodenectomy for locally advanced colon carcinoma—feasibility in patients presenting with acute abdomen

Abstract Background En bloc right hemicolectomy plus pancreaticoduodenectomy (PD) is administered for locally advanced colon carcinoma that invades the duodenum and/or pancreatic head. This procedure may also be called colo-pancreaticoduodenectomy (cPD). Patients with such carcinomas present acute abdomen. Emergency PD often leads to high postoperative morbidity and mortality. Here, we aimed evaluate feasibility outcomes of emergency cPD patients manifesting as Methods We retrospectively reviewed 4898 colorectal cancer who underwent curative colectomy during period from 1994 2018. Among them, 30 had received cPD. surgery was performed in 11 conditions (bowel obstruction: 6, perforation: 3, tumor bleeding: 2). Selection criteria were following: (1) age ≤ 60 years, (2) body mass index < 35 kg/m 2 , (3) no poorly controlled comorbidities, (4) perforation time 6 h. Three did not meet above non-emergency after a life-saving diverting ileostomy, followed by 3 months later. analyzed these terms their clinicopathological characteristics, early long-term outcomes, compared findings between group (e-group, n = 11) (non-e-group, 19). After cPD, staged pancreaticojejunostomy all e-group patients, on 15 19 non-e-group. Results The non-e-group older higher incidence associated while other characteristics similar two groups. None groups succumbed complication rate 63.6% 42.1% ( p 0.449). 5-year overall survival 15.9% 52.6% 0.192). Conclusions feasible highly selected if experienced surgeons. positive are those abdominal conditions.