64 year old male patient presented with abdominal and back pain for 6 months, anorexia, loss of weight and new onset uncontrolled diabetes. During investigations for the same, PET-CT showed a 2cm tumor in the body of pancreas in a very tricky location (between important artery supplying the spleen and the vein draining towards liver. An endoscopic ultrasound (EUS) guided biopsy confirmed it as a pancreatic cancer.
Since the tumor was resectable and there were no metastasis (spread), patient was immediately operated without wasting further time. Prior to surgery patient & family were explained in great detail about the nature / extent of surgery (radical pancreatosplenectomy – removal of part of pancreas, surrounding draining lymph nodes & attached spleen as a one continuous specimen), possible perioperative complications / risk, duration of stay, expenses & a possibility of postoperative chemotherapy need. Also patient was vaccinated prior to surgery for avoiding infections after splenectomy. The diabetes was controlled with insulin and then patient underwent a radical pancreatosplenectomy. Patient did well after surgery and was discharged on 7th day.
The histopathology proved that the tumor was removed in entirety along with nodal tissue. Based on the final pathological stage of disease, it was decided to give adjuvant chemotherapy. A chemoport was placed for the same and chemotherapy was started 4 weeks after the surgery.
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