An adult presented with hematemesis and upper abdominal pain. Endoscopy revealed a growth at the pyloric antrum of the stomach. CT scan showed growth involving the pyloric antrum without infiltration or invasion into surrounding structures and no evidence of distant metastasis. At laparotomy neoplastic growth was observed to involve the posterior wall of the stomach and the pancreas extending 6cm up to the tail of the pancreas. What will be the most appropriate surgical management
Palliative procedures like palliative paial gastrectomy, anterior gastrojejunostomy, Devine's exclusion procedure, luminal stenting in proximal inoperable growths, chemotherapy are used in inoperable cases. * In early carcinoma proper lymph nodal clearance is impoant. Antrectomy is also called as hemi-gastrectomy. Removal of 60-75% stomach is called a paial gastrectomy. Removal of more than 80% of the stomach is called a subtotal gastrectomy. Distal pancreatectomy or central pancreatectomy or total pancreatectomy for cystadenocarcinoma of pancreas depending on the extent and size of a tumour . Ref: SRB&;s manual of surgery,3 rd ed, pg no 636
Closure of the abdomen
Antrectp, u amd vagotomy
Paial gastrectomy + Distal pancreatectomy
Paial gastrectomy + Distal pancreatectomy + splenectomy
G.I.T