Pancreas-Sparing Duodenal Resection in Colorectal Adenocarcinoma With Local Invasion of the Duodenum: A Case Report.

A 53-year-old male patient presented with right upper abdominal pain, anemia, and weight loss. Colonoscopy revealed a non-obstructing hepatic flexure growth, and biopsy confirmed moderately differentiated adenocarcinoma. Imaging showed a non-metastatic, locally advanced right colon malignancy involving the ascending colon, hepatic flexure, and proximal transverse colon, with invasion into the pylorus of the stomach and second/third parts of the duodenum, pericolonic nodes, and segmental superior mesenteric vein (SMV) abutment. Following five cycles of neoadjuvant chemotherapy with stable disease on positron emission tomography-computed tomography (PET-CT), the patient underwent an en bloc right hemicolectomy with pancreas-sparing duodenal resection (PSDR). The postoperative course was uneventful, and the patient recovered well. This case highlights PSDR as a feasible alternative to pancreaticoduodenectomy (PD) in select cases of locally advanced right colon cancer (LARCC) invading the duodenum, preserving pancreatic function and reducing morbidity.