title: Laparoscopic-assisted pancreaticoduodenectomy in a child with gastrinoma.
abstract: Gastrinoma is rare in children. We report the case of a 9-year-old boy with weight loss and vomiting. Upper gastrointestinal imaging showed severe stenosis of the duodenum. Although gastrin was very high, imaging did not show a gastrinoma. Selective arterial secretagogue injection (SASI) test indicated a tumor within the gastroduodenal arterial zone. In accordance with the SASI test result, we performed laparoscopic-assisted pancreaticoduodenectomy (LAPD). Postoperative biochemistry confirmed complete resection of the gastrinoma, and the patient was asymptomatic at follow up, 30 months after surgery. Even in patients with negative imaging for gastrinoma, aggressive resection following accurate localization on SASI test is biochemically curative. In such cases, the tumor is probably very small and LAPD may offer a minimally invasive procedure. As far as we know, LAPD in a child has not been previously reported.
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Murase
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Tainaka
authors.affiliation: Departments of Pediatric Surgery, Pathology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawashima
authors.affiliation: Departments of Pediatric Surgery, Pathology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Departments of Pediatric Surgery, Pathology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Hizuru
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Pathology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kishimoto
mesh_terms: D002648:Child; D005500:Follow-Up Studies; D015408:Gastrinoma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: gastrinoma; laparoscopic-assisted pancreaticoduodenectomy; pediatric; selective arterial secretagogue injection test