Caudal pancreatic body cancer Caudal pancreatic body cancer is a kind of digestive system tumor with insidious onset, rapid progression, poor prognosis and extremely high malignancy, the incidence of which is increasing year by year worldwide. Clinical manifestations: The early stage of pancreatic body tail cancer lacks typical clinical manifestations. The non-specific symptoms such as epigastric discomfort, emaciation, poor appetite and abdominal distension appearing in the early stage of patients are often misdiagnosed as other diseases such as gastritis and ignore the diagnosis of pancreatic body tail cancer. Patients with significant weight loss in a short period of time and sudden onset of diabetes should be alerted to the presence of caudal pancreatic cancer. Once the patient has persistent low back pain or palpable swelling in the abdomen, the tumor has developed to advanced stage. Diagnosis: Ultrasound, CT and MRI can diagnose pancreatic tumor of 1 cm in diameter, and for cases that are difficult to diagnose clearly, fine needle aspiration under endoscopic ultrasound guidance is feasible. tumor markers such as CA199 and CEA are often significantly elevated. Treatment: The efficacy of radiotherapy and chemotherapy for pancreatic cancer is not satisfactory, and surgical resection of the tumor is the only way for patients to obtain long-term survival. However, in the past, the tumor has already invaded the main blood vessels and surrounding organs such as the celiac trunk, superior mesenteric artery and superior mesenteric vein when the patient was diagnosed, so radical treatment is not possible. Numerous studies have shown that the median survival of the radically resected group is significantly longer than that of the unresected group, and even if palliative resection is performed in cases where radical resection is not possible, the survival time is significantly better than that of the unresected group. Therefore, if there is no distant metastasis, even if the tumor invades several organs, combined organ resection should be actively pursued, and postoperative radiotherapy and chemotherapy should be supplemented to improve survival and quality of life. Features of our department: At present, our department utilizes the concept of precision surgery to save the lives of a number of patients with advanced pancreatic body tail cancer by performing combined multiple organ resection of the left upper abdomen, laparotomy and retroperitoneal lymph node dissection through careful preoperative surgical planning. A 72-year-old female patient was admitted to our department. She had been suffering from abdominal distension for several months and black stool for 2 weeks. Gastroscopy revealed a huge 6-8 cm ulcerated lesion on the posterior wall of the gastric body, and CT examination revealed a huge tumor in the caudal part of the pancreatic body, invading the gastric wall, multiple enlarged lymph nodes next to the abdominal aorta, and involvement of the splenic artery and inferior mesenteric vein, and regional portal hypertension. We performed caudal pancreatic body + splenectomy + total gastrectomy + oesophago-jejunal Roux-en-Y anastomosis for the patient. The tumor invaded the posterior wall of the gastric body and penetrated into the gastric cavity, forming an ulcerated surface of 6 cm in diameter. The tumor invaded the superior mesenteric vein, splenic vein and inferior mesenteric vein, invaded the beginning of the abdominal trunk, wrapped around from the beginning of the splenic artery and spread to the foot of the diaphragm and the beginning of the jejunum, and involved the transverse colonic mesentery. Metastatic lymph nodes of 2 cm in diameter were seen under the left renal vein. The bleeding during the whole operation did not exceed 200 ml, and such advanced pancreatic body tail cancer could not be resected radically in the past.