Unexpected duodenopancreatectomy in an “awake” gastrectomized patient: Case report and technical notes

Abstract A patient with a previous history of gastric cancer was admitted to our unit with fever and jaundice. Preoperative evaluation showed the presence of calculi of the common bile duct (CBD). During the preoperative anaesthetic evaluation, neuraxial-type anaesthesia was proposed given the patient’s frailty. Exploration of the CBD revealed neoplastic tissue involving the ampulla of Vater. A duodenopancreatectomy was performed under neuraxial anaesthesia. A modified reconstruction was performed, and a mechanical stapler for hepaticojejunal (HJ) anastomosis was used. The