Modified Cattell's reconstruction with pancreaticogastrostomy following pylorus-preserving pancreaticoduodenectomy for a patient with gastroptosis.

Gastroptosis is a condition in which the stomach is enlarged and located in an abnormally low position, which impedes normal stomach function. A patient with gastroptosis has equivocal complaints such as nausea, stomach fullness and abdominal pain. Pylorus-preserving pancreaticoduodenectomy (PPPD) has a better outcome than the Whipple procedure in terms of operative mortality and morbidity, and postoperative nutritional state. However, delayed gastric emptying (DGE) is frequently observed after PPPD. If PPPD is performed for a patient with gastroptosis, the risk of postsurgical DGE may increase. Therefore, we have developed a modified Cattell's reconstruction with pancreaticogastrostomy (PG) after PPPD to prevent DGE in a patient with gastroptosis and adenocarcinoma of the ampulla of Vater.