Article Data

  • Views 2376
  • Dowloads 185

Original Research

Open Access

Outcomes after combined right hemicolectomy and pancreaticoduodenectomy for locally advanced right-sided colon cancer: a case series

  • Server Sezgin Uludag1
  • Ahmet Necati Sanli2
  • Ozan Akinci3
  • Deniz Esin Tekcan Sanli4
  • Abdullah Kagan Zengin5

1Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul, Turkey

2Istanbul Kartal Dr Lutfi Kirdar Training and Researching Hospital, Department of General Surgery, Istanbul, Turkey

3Acibadem Kozyatagi Hospital, Department of Radiology, Istanbul, Turkey

DOI: 10.22514/sv.2020.16.0095 Vol.17,Issue 2,March 2021 pp.154-159

Published: 08 March 2021

*Corresponding Author(s): Server Sezgin Uludag E-mail:


Background: Although right colon cancers mostly grow intraluminally, they may rarely invade neighboring organs without distant organ metastasis. En bloc resection is required for R0 resection in pancreas and duodenum-invasive right colon tumors. Despite the high mortality and morbidity rates, the en bloc right hemicolectomy and pancreaticoduodenectomy (RHPD) procedure can be safely performed in centers experienced in colorectal and hepatobiliary surgery.

Objective: In this study, we aimed to share the results of our patients who underwent en bloc pancreaticoduodenectomy in addition to right hemicolectomy for cases with locally advanced right colon cancer.

Materials and Methods: Patients who were operated on the right colon cancer between January 2010 and March 2018 were retrospectively screened. Patients who underwent RHPD due to locally advanced colon cancer invading the duodenum and pancreas were included in this study. RHPD was performed in cases where radical resection was deemed appropriate, and R0 resection could be performed. Demographic information, intraoperative and postoperative findings, and long-term follow-up data of the patients were recorded.

Results: Six cases underwent RHPD. All of the cases were male, and the mean age was 67 ± 6. Proximal PD was performed in five cases, and total PD was performed in one case. SMV reconstruction was performed in one case with an SMV invasion. One case died due to pneumonia and anastomotic leak in the postoperative period. The other five patients had a mean disease-free survival of 29.2 ± 14.7 months. The 1 and 2-year survival rate was 66.6% and 66.6%, respectively.

Conclusion: RHPD is a surgical operation that can be performed safely in experienced centers with acceptable mortality and morbidity rates in cases suitable for R0 resection.


Locally advanced right-sided colon cancer; Right hemicolectomy; Pancreaticoduo-denectomy

Cite and Share

Server Sezgin Uludag,Ahmet Necati Sanli,Ozan Akinci,Deniz Esin Tekcan Sanli,Abdullah Kagan Zengin. Outcomes after combined right hemicolectomy and pancreaticoduodenectomy for locally advanced right-sided colon cancer: a case series. Signa Vitae. 2021. 17(2);154-159.


[1] Ağalar C, Canda AE, Unek T, Sokmen S. En bloc pancreaticoduodenec-tomy for locally advanced right colon cancers. International Journal of Surgery Oncology. 2017; 2017: 5179686.

[2] Kaneda Y, Noda H, Endo Y, Kakizawa N, Ichida K, Watanabe F, et al. En bloc pancreaticoduodenectomy and right hemicolectomy for locally advanced right-sided colon cancer. World Journal of Gastrointestinal Oncology. 2017; 9: 372-378.

[3] Sheng QS, Chen WB, Li MJ, Cheng XB, Wang WB, Lin JJ. Combined right hemicolectomy and pancreaticoduodenectomy for locally advanced right hemicolon cancer. Hepatobiliary & Pancreatic Diseases Interna-tional. 2015; 14: 320-324.

[4] Cirocchi R, Partelli S, Castellani E, Renzi C, Parisi A, Noya G, et al. Right hemicolectomy plus pancreaticoduodenectomy vs partial duodenectomy in treatment of locally advanced right colon cancer invading pancreas and/or only duodenum. Surgical Oncology. 2014; 23: 92-98.

[5] Bacon HE. Factors influencing prognosis, including complications prior to definitive surgery. In: Bacon HE, editor. Cancer of the colon, rectum and anal canal. Philadelphia: JB Lippincott. 1964; pp 479e96.

[6] Lehnert T, Methner M, Pollok A, Schaible A, Hinz U, Herfarth C. Multivisceral resection for locally advanced primary colon and rectal cancer: an analysis of prognostic factors in 201 patients. Annals of Surgery. 2002; 235: 217-225.

[7] Hakimi AN, Rosing DK, Stabile BE, Petrie BA. En bloc resection of the duodenum for locally advanced right colon adenocarcinoma. The American Surgeon. 2007; 73: 1063-1066.

[8] Li D, Si X, Wan T, Zhou Y. A pooled analysis of en bloc right hemicolectomy with pancreaticoduodenectomy for locally advanced right-sided colon cancer. International Journal of Colorectal Disease. 2018; 33: 819-822.

[9] Chakedis J, Schmidt CR. Surgical treatment of metastatic colorectal cancer. Surgical Oncology Clinics of North America. 2018; 27: 377-399.

[10] Dighe S, Purkayastha S, Swift I, Tekkis PP, Darzi A, A’Hern R, Brown G. Diagnostic precision of CT in local staging of colon cancers: a meta-analysis. Clinical Radiology. 2010; 65: 708-719.

[11] Kapoor S, Das B, Pal S, Sahni P, Chattopadhyay TK. En bloc resection of rightsided colonic adenocarcinoma with adjacent organ invasion. International Journal of Colorectal Disease. 2006; 21: 265-268.

[12] Lee WS, Lee WY, Chun HK, Choi SH. En bloc resection for right colon cancer directly invading duodenum or pancreatic head. Yonsei Medical Journal. 2009; 50: 803-806.

[13] Berrospi F, Celis J, Ruiz E, Payet E. En bloc pancreaticoduodenectomy for right colon cancer invading adjacent organs. Journal of Surgical Oncology. 2002; 79: 194-197.

[14] Zhao YZ, Han GS, Lu CM. Right hemicolectomy and multivisceral resection of right colon cancer: A report of 21 cases. Journal of Huazhong University of Science and Technology [Medical Sciences]. 2015; 35: 255- 258.

[15] Kama NA, Reis E, Doganay M, Gozalan U, Yasti C. Radical surgery of colon cancers directly invading the duodenum, pancreas and liver. Hepatogastroenterology. 2001; 48: 114-117.

[16] Patel SA, Zenilman ME. Outcomes in older people undergoing operative intervention for colorectal cancer. Journal of the American Geriatrics Society. 2001; 49: 1561-1564.

[17] Otchy D, Hyman NH, Simmang C, Anthony T, Buie WD, Cataldo P, et al. Practice parameters for colon cancer. DDiseases of the Colon & Rectum. 2004; 47: 1269-1284.

[18] Song XM, Wang L, Zhan WH, Wang JP, He YL, Lian L, et al. Right hemicolectomy combined with pancreatico- duodenectomy for the treatment of colon carcinoma invading the duodenum or pancreas. Chinese Medical Journal (Engl). 2006; 119: 1740-1743.

[19] Davydov MI, Rasulov AO, Tamrazov RI, Nekhaev IV. Pravostoron-nyaya gemikolektomiya s gastropankreatoduodenal’noi rezektsiei pri oslozhnennom mestno-rasprostranennom rake pravoi poloviny tolstoi kishki u patsienta starcheskogo vozrasta [Right-sided hemicolectomy with gastropancreatoduodenectomy for complicated right-sided locally-advanced colon cancer in elder patient]. Khirurgiia (Mosk). 2016; 7: 72- 76. (In Russian)

[20] Khalili M, Daniels L, Gleeson EM, Grandhi N, Thandoni A, Burg F, et al. Pancreaticoduodenectomy outcomes for locally advanced right colon cancers: A systematic review. Surgery. 2019; 166: 223-229.

[21] Costa SR, Henriques AC, Horta SH, Waisberg J, Speranzini MB. En-bloc pancreatoduodenectomy and right hemicolectomy for treating locally advanced right colon cancer (T4): a series of five patients. Arquivos De Gastroenterologia. 2009; 6: 151-153.

[22] Saiura A, Yamamoto J, Ueno M, Koga R, Seki M, Kokudo N. Long-term survival in patients with locally advanced colon cancer after en bloc pancreaticoduodenectomy and colectomy. Diseases of the Colon & Rectum. 2008; 51: 1548-1551.

[23] Zhang J, Leng JH, Qian HG, Qiu H, Wu JH, Liu BN, et al. En bloc pancreaticoduodenectomy and right colectomy in the treatment of locally advanced colon cancer. Diseases of the Colon & Rectum. 2013; 56: 874-880.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time