Pylorus-Preserving Pancreatoduodenectomy for Ampullary Carcinoma after Esophagectomy with Retrosternal Ileocolonic Interposition: A Case Report

Introduction

Pancreatoduodenectomy after esophagectomy with an ileocolonic interposition is technically challenging because perfusion of both the remnant stomach and the interposed ileocolonic conduit must be preserved. Although pancreatic head resection after proximal gastrectomy or gastric conduit reconstruction has been reported, pylorus-preserving pancreatoduodenectomy (PPPD) after an ileocolonic interposition has not been previously reported. We report a case of PPPD after an ileocolonic interposition in which both the right gastroepiploic vessels and the middle colic arterial arcade were preserved, and intraoperative indocyanine green (ICG) fluorescence imaging was used to confirm adequate perfusion.