Whipple's Pancreaticoduodenectomy Requiring Total Gastrectomy

Multiple neoplastic lesions at separate gastrointestinal sites is rare with incidence of 0.7-11%. Majority primary neoplasms (MPN's) are double while triple/quadruple malignancies extremely a ratio 2.7:1. Patients periampullary having lesion in stomach or gastroesophageal junction rare. These patients requiring Whipple's pancreaticoduodenectomy (PD) resection the adjoining for R0 Resection rarely reported. Material and methods: We report three cases carcinoma associated two GE pylorus one. have undergone PD subtotal total gastrectomy reconstruction. Usually shall require antrum gastrojejunostomy. If preserving done then duodenojejunostomy required In presented here, we did proximal gastrojejunostomy esophagojejunostomy one patient. all these surgeries feeding jejunostomy was done. All had smooth postoperative course. Two GIST on biopsy. One patient no evidence malignancy spite PET positive pylorus. Conclusion: en mass feasible option multiple (duodenum, oesophagus).