Abstract
IntroductionLaparoscopic distal pancreatectomy has been described for more than a decade now and has been considered technically feasible, safe, and with reproducible outcomes. It seems to exhibit several benefits of minimally invasive surgery and should be performed in carefully selected patients.Case presentationWe report the case of a 55-year-old Greek woman with a solid pseudopapillary tumor of the tail of the pancreas. She underwent a laparoscopic distal pancreatectomy and splenectomy. The histopathologic examination finally revealed a cystic-solid pseudopapillary neoplasm of the pancreas. Solid pseudopapillary tumors of the pancreas are rare and affect predominantly young women. These tumors are of unclear pathogenesis and low malignancy, and surgical resection offers an excellent chance for long-term survival.ConclusionThis case report indicates that in selected centers and for selected patients, laparoscopic distal pancreatectomy is feasible. The benign characteristics of these tumors make them ideal for laparoscopic excision.
Highlights
Laparoscopic distal pancreatectomy has been described for more than a decade and has been considered technically feasible, safe, and with reproducible outcomes
Solid pseudopapillary tumors (SPTs) of the pancreas are rare and affect predominantly young women. These tumors are of unclear pathogenesis and low malignancy, and surgical resection offers an excellent chance for long-term survival [4]
The larger review contains 718 well-documented cases and confirms the characteristics of these tumors [4]. They appear as slowly growing masses with or without pain; these tumors may appear with other rare symptoms [5]
Summary
Laparoscopic resection of the pancreas was initially described experimentally in the early 1990s [1]. Just after a modified radical left mastectomy had been performed, we further investigated the pancreatic lesion with a magnetic resonance imaging (MRI) scan, which revealed a space-occupying cystic lesion of maximum diameter of 5 cm located in the tail of the pancreas with calcifications of the wall and a. We used a five-port technique, placing a 12 mm trocar left paramedian at about the level of the umbilicus, a 10 mm-trocar in the left upper quadrant of the abdomen on the anterior axillary line, a 10 mm-trocar in the subxiphoid region, a 5 mm-trocar in the left hypochondrium on the midclavicular line, and a 5 mm-trocar in the right hypochondrium in the midclavicular line as well (Figure 2). The patient’s follow-up (with abdominal CT and biochemical tests yearly) in a time period of 36 months revealed no disease recurrence or development of diabetes
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