Radical total gastrectomy plus D2 dissection for gastric cancer

A 78-year-old male was presented in our hospital. His preoperative CT and B-mode ultrasound showed no liver or lung metastasis. Enlarged lymph nodes (1-2 cm in diameter) were found around the stomach and near the common bile duct. These masses invaded the serous layer. However, no enlarged lymph node was detected after peritoneum or near abdominal aorta. Pre-operative chemotherapy was not feasible for such an elderly patient. Radical surgery was then scheduled.