[Laparoscopic segmental pancreas resection and pancreatic cystadenoma].
Aside from location, the complex anatomic relationships and advanced laparoscopic skills needed in selected cases of laparoscopic pancreas surgery have increased. We report a 55-year-old woman with cystic adenoma in the area of the corpus who was treated with complete laparoscopic corpus resection while preserving the head and tail of the pancreas and the spleen. The patient was placed in lithotomy position. Four trocars were placed. After opening the bursa, the pancreas showed a 6x6x6-cm, well-bordered, cystic tumor in the corpus. Tail and head of the pancreas were free of tumor and seemed inconspicuous. After exploration of the v. porte and v. lienalis, the healthy tissue in the head area of the pancreas was divided with the linear stapler. Preparation continued in the direction of the pancreatic tail while preserving the v. lienalis. After reaching the healthy pancreas in the tail region, the tumorous segment was resected. The resected pancreas segment was placed in an endobag until removal over a slightly widened trocar incision above the symphysis. The tail segment was anastomized in situ end-to- side with the first jejunum loop behind the Treitz's ligament. There was no postoperative complication, and the postoperative course was observed. The patient returned to normal activity within 10 days after operation. Retaining high surgical standards and preserving the healthy pancreas tissue and laparoscopic anastomosis, laparoscopic surgery in cases of benign tumors of the distal pancreas is possible with all the patient benefits of minimally invasive surgery.
Baca
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Klinik für Allgemein- und Unfallchirurgie, Zentralkrankenhaus Bremen Ost, Lehrkrankenhaus der Universität Göttingen, Bremen. baca@zkhost.bremen.de
Bokan
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D000714:Anastomosis, Surgical; D003537:Cystadenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D013528:Surgical Staplers; D016896:Treatment Outcome