Esophagectomy and pancreatoduodenectomy in the same patient: tactical and technical considerations.

Esophagectomy (EE) and pancreatoduodenectomy (PDE) are considered the most invasive and technically demanding surgical procedures performed on the digestive organs. These surgical interventions significantly change the normal anatomic relationships in the upper abdomen. Any additional digestive surgeries, especially resectional procedures, performed after a prior EE or PDE can be extremely difficult. The cases of simultaneous or metachronous EE and PDE in the same patient are very interesting from both a scientific and a practical viewpoint. We collected and analyzed the existing literature data on EE and PDE in the same patient. There were 60 cases: 3 cases of EE after PDE, 22 cases of PDE after EE, and 35 cases of simultaneous EE and PDE. The technical and tactical features of the surgery in a different sequence of stages or in a simultaneous procedure are discussed in a review.