[Recurrent neoplasm in the gastric stump, penetrating the pancreas. Total gastrectomy, total duodenopancreatectomy. Problems of surgical technic].

The authors performed a new surgical intervention in a patient with cancer of the gastric stump recidivating after a resection performed two years previously. Due to the extension of the tumour, and to involvement of the pancreas it was necessary to perform total gastrectomy, associated with splenectomy and total pancreatectomy. The refection of the continuity of the digestive-biliary pathways was achieved by eso-jejunostomy of the termino-terminal type associated with choledocho-jejunostomy on omega loop excluded from the digestive pathway by way of the Braun-type fistula. A knowledge of the solution selected by the authors is interesting due to the total pancreatectomy associated to total gastrectomy, and for the surgical technique employed.