Pancreas-sparing tumor enucleation for pancreatic mucinous cystic neoplasms: experience with two patients.
BACKGROUND
Because mucinous cystic neoplasms (MCNs) occur in the body and tail of the pancreas, distal pancreatectomy has been conventionally performed. However, enucleation can be adopted in selected patients, preserving the pancreatic parenchyma.


METHODS
We experienced two patients with MCN who underwent pancreatic tumor enucleation. Case 1 involved a very large MCN, 23 cm across. Connective tissues between the tumor and the pancreatic parenchyma were not dense, so it was relatively easy to perform pancreatic cyst resection. Case 2 involved a MCN, 5 cm across, located next to the body of the pancreas. Fibrotic changes were so dense that it was difficult to separate the tumor from the pancreatic parenchyma. Careful and gentle dissection enabled pancreas-sparing enucleation without injury to the cyst wall.


RESULTS
Enucleation of MCNs were performed successfully, preserving the pancreatic parenchyma. No complications were observed in either case.


CONCLUSIONS
It is important to adopt the appropriate surgical procedure for MCN, considering the balance between radical resection and preservation of pancreatic function. Although careful attention should be paid to the assessment of malignant potential in each case of MCN, pancreas-sparing tumor enucleation can be considered as one of the treatment options in selected patients.
Ohigashi
Seiji
S
Department of Surgery, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Shimada
Gen
G
Suzuki
Akihiro
A
Onodera
Hisashi
H
D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance; D018282:Cystadenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D004210:Dissection; D005260:Female; D005355:Fibrosis; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed