Introduction : PD following gastrectomy or gastrojejunostomy is a difficult task, because of adhesions and the varying anatomical structures of the remaining organs. The aim of this study is to evaluate the surgical outcomes of PD following gastrectomy.

Methods : We retrospectively reviewed eight consecutive pancreaticoduodenectomied patients who underwent curative PD with a history of partial gastrectomy or gastrojejunostomy between 2004.5 and 2015.2 at Hallym University Sacred Heart Hospital, in Anyang, Koera. Among 162 patients, Distal gastrectomy was performed in four patients and all were reconstructed with the B-II gastrectomy. Two patients underwent total gastrectomy, reconstructed with the R-Y method. And two patients underwent gastrojejunostomy.

Results : The mean age was 63 years (range 51–77). The indication for gastrectomy was gastric cancer in five, gastric ulcer bleeding in one. Gastrojejunostomy was performed for duodenal ulcer obstruction in two patients. While preserving the existing gastrojejunostomy or esophagojejunostomy, pancreaticojejunostomy and hepaticojejunostomy were performed by the Roux-en-Y method using a new Roux limb in all cases. Indications for PD included CBD cancer in three, AOV cancer in one, duodenal cancer in one, recurred cancer of duodenal stump in two, and benign biliary stricture in one patient. The interval between the two operations ranged from 0.6 to 40 years (mean 12.7 ). Mean surgical time for PD was 503 min (range 405–670). Postoperative pancreatic fistula were developed in two patients, one of these underwent reoperation.

Conclusions : The PD following gastric resection or gastrojejunostomy is challenging procedure. But we believe that PD following gastrectomy or gastrojejunostomy can be safely performed.