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[The effectiveness of reduction surgery and gemcitabine for multiple bowel obstructions due to peritoneal dissemination of pancreatic carcinoma with liver metastasis--a case report].

A 62-year-old woman visited our hospital because of the increasing lower left abdominal distention. Computed tomography (CT) revealed pancreatic carcinoma invading to spleen with liver metastasis and peritoneal dissemination. Soon after, the patient showed a severe bowel obstruction symptom, so we performed an emergency operation. The pancreatic carcinoma was located at the tail of pancreas invading to spleen with liver metastasis. Due to peritoneal dissemination, severe stenosis and dilatation of the small intestine, stenosis of the ascending and sigmoid colon was admitted. We performed a distal pancreatectomy, partial hepatectomy, partial resection of the stomach, five-partial resection of the small intestine, right colectomy and sigmoidectomy. No operative complication was seen, and we started chemotherapy using gemcitabine soon after the operation. After 3 months, the tumor markers normalized. She was able to finish intestinal nutrition 8 months after the operation. At present (20 months after the operation), the patient is still alive with good performance status (PS 0). The removal of bowel obstruction by operation enabled us to perform intestinal nutrition and sufficient chemotherapy, which may lead to the favorable prognosis.