Medial pancreatectomy for a neuroendocrine tumor invading the splenic artery and vein.
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.
Ait-Ali
Abdelmounaim
A
Department of Digestive Surgery 1, Mohammed V Military Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Sall
Ibrahima
I
El-Kaoui
Hakim
H
Bouchentouf
Sidi Mohammed
SM
El-Hjouji
Abderrahmane
A
Rouibaa
Fadwa
F
Benkirane
Ahmed
A
Bounaim
Ahmed
A
Zentar
Aziz
A
Sair
Khalid
K
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*