title: Medial pancreatectomy for a neuroendocrine tumor invading the splenic artery and vein.
abstract: BACKGROUND
  Pancreatic tumors in the midportion have traditionally been treated by an extended right or left pancreatectomy. A medial or central pancreatectomy is an alternative technique for benign or low-grade malignant neoplasms located to the left of the gastroduodenal artery and close to the splenomesenteric confluence.
  
  
  METHODS
  A 38-year-old woman with no previous surgical history presented with epigastric abdominal pain. A computed tomography scan showed a 4 cm heterogeneous lesion within the pancreatic body. This tumor invaded the splenic artery and vein. There was no postoperative diabetes mellitus or exocrine insufficiency. The patient continues to be well after a 10-month follow-up without pancreatic insufficiency or local recurrence, and CT has demonstrated splenic perfusion by the collateral vessels.
  
  
  CONCLUSIONS
  We believe that a medial or central pancreatectomy may be a safe procedure where there is involvement of the large splenic vessels by a low grade malignant pancreatic tumor and that a systematic splenectomy is not justified.
authors.affiliation: Department of Digestive Surgery 1, Mohammed V Military Hospital, Mohammed V University of Rabat, Rabat, Morocco.
authors.forename: Abdelmounaim
authors.initials: A
authors.lastname: Ait-Ali
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Sall
authors.forename: Hakim
authors.initials: H
authors.lastname: El-Kaoui
authors.forename: Sidi Mohammed
authors.initials: SM
authors.lastname: Bouchentouf
authors.forename: Abderrahmane
authors.initials: A
authors.lastname: El-Hjouji
authors.forename: Fadwa
authors.initials: F
authors.lastname: Rouibaa
authors.forename: Ahmed
authors.initials: A
authors.lastname: Benkirane
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bounaim
authors.forename: Aziz
authors.initials: A
authors.lastname: Zentar
authors.forename: Khalid
authors.initials: K
authors.lastname: Sair
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D013157:Splenic Artery / Q000473:pathology / Q000601:surgery*; D013160:Splenic Neoplasms / Q000517:prevention & control / Q000556:secondary; D013162:Splenic Vein / Q000473:pathology / Q000601:surgery*