Surgical Treatment of Pancreatic Head Cancer and Perioperative Management in High Thromboembolic Risk Patients With Recent Drug-Eluting Coronary Stent Implantation

Abstract

Patients with multiple coronary artery diseases, especially with recent implantation of a drug-eluting coronary stent (DES), require strong dual antiplatelet therapy and regarded as those with very high thromboembolic risks. When these patients undergo major abdominal surgery for malignancy, perioperative risks including bleeding and thromboembolic risks have to be balanced against oncological radicality. We performed successful management of 81-year-old man suffering locally advanced pancreatic head cancer detected just after recent DES implantation. Curative-intent pancreaticoduodenectomy under preoperative continuation of aspirin monotherapy is safe and feasible, and is considered to be one of the promising options for the treatment of such complicated patients.