title: Laparoscopic fenestration of pancreatic serous cystadenoma: Minimally invasive approach for symptomatic benign disease.
abstract: Serous cystadenoma (SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the literature. In this study, 3 female patients underwent laparoscopic fenestration for macrocystic SC (12-14 cm). Diagnosis was established via magnetic resonance imaging and endoscopic ultrasound, with intra-cystic dosage of tumors markers (ACE and CA19-9) in 2 patients. All patients were symptomatic and operated on 15-60 mo after diagnosis. Radiological evaluation showed constant cyst growth. Patients were informed about this new surgical modality that can avoid pancreatic resection. The mean operative time was 103 min (70-150 min) with one conversion. The post-operative course was marked by a grade A pancreatic fistula in one patient and was uneventful in the other two. The hospital stay was 3, 10, and 18 d, respectively. The diagnosis of macrocystic SC was histologically-confirmed in all cases. At the last follow-up (13-26 mo), all patients were symptom-free, and radiological evaluation showed complete disappearance of the cyst. Laparoscopic fenestration, as opposed to resection, should be considered for large symptomatic macrocystic SC, thereby avoiding pancreatic resection morbidity and mortality.
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Safi
authors.initials: S
authors.lastname: Dokmak
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Aussilhou
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Fanjandrainy
authors.initials: F
authors.lastname: Rasoaherinomenjanahary
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Sauvanet
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Vullierme
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Vinciane
authors.initials: V
authors.lastname: Rebours
authors.affiliation: Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lévy
mesh_terms: D000328:Adult; D000368:Aged; D018395:CA-19-9 Antigen / Q000032:analysis; D018293:Cystadenoma, Serous / Q000737:chemistry / Q000150:complications / Q000473:pathology / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000150:complications / Q000473:pathology / Q000601:surgery*; D007703:Peptidyl-Dipeptidase A / Q000032:analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018395:CA-19-9 Antigen; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A
keywords: Laparoscopic fenestration; Pancreatic serous cystadenoma; Symptomatic