scholarly journals Distal pancreatectomy: en‐bloc splenectomy vs spleen‐preserving pancreatectomy

HPB ◽  
2005 ◽  
Vol 7 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Laureano Fernández‐Cruz ◽  
David Orduña ◽  
Gleydson Cesar‐Borges ◽  
Miguel Angel López‐Boado
Keyword(s):  
Distal Pancreatectomy ◽  
En Bloc ◽  
Spleen Preserving

Symptomatic pancreatic body endometrial cyst requiring en bloc distal pancreatectomy

2021 ◽  
Vol 14 (9) ◽  
pp. e244911
Author(s):  
Cameron Ludwig ◽  
Avery Kopacz ◽  
M Logan Warren ◽  
Edwin Onkendi
Keyword(s):  
Distal Pancreatectomy ◽  
Surgical Resection ◽  
Epigastric Pain ◽  
Rare Condition ◽  
The Body ◽  
Uneventful Recovery ◽  
En Bloc ◽  
Spleen Preserving ◽  
Robotic Resection ◽  
Endometrial Cyst

Pancreatic endometriosis is an extremely rare condition, with only a few cases described in the literature. Definitive diagnosis is often difficult to elucidate and will almost always require biopsy or surgical resection. We present a case of a female in her early thirties with a well-known history of widespread endometriosis presenting with vague epigastric pain. CT imaging showed an 11 cm well-circumscribed simple-appearing cyst in the lessor sac. Its origin could not be determined preoperatively but it appeared to involve the parenchyma of the body of the pancreas. Due to the associated pain and indeterminate nature, subtotal surgical resection of the extrapancreatic cyst was performed with the intrapancreatic cyst being managed by a cystogastrostomy to the adjacent stomach in a planned pancreas-sparing procedure following intraoperative confirmation it was arising within the pancreas. Pathological evaluation of the resected cyst confirmed it to be an endometrial cyst. The cystogastrostomy anastomosis subsequently obstructed a few weeks postoperatively and symptoms recurred from cyst enlargement. Redo robotic resection with resection of the remnant cyst, cystogastrostomy and en bloc spleen-preserving distal pancreatectomy was performed. The patient had an uneventful recovery. She has had no recurrence of cyst or symptoms since. A procedure video is included in the report.

scholarly journals Laparoscopic spleen preserving distal pancreatectomy with intra-operative assessment and frozen section may prevent unnecessary splenectomy

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S933-S934
Author(s):  
L. Tanno ◽  
N. Siddiqi ◽  
S. Barbaro ◽  
M. Fontana ◽  
A. Jayyusi ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Frozen Section ◽  
Spleen Preserving ◽  
Operative Assessment

scholarly journals Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Willemijn P. M. van Dijck ◽  
Vincent P. Groot ◽  
Lodewijk A. A. Brosens ◽  
Jeroen Hagendoorn ◽  
Inne H. M. Borel Rinkes ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Accessory Spleen ◽  
Magnetic Resonance Images ◽  
Epithelial Cyst ◽  
Robot Assisted ◽  
Diagnostic Features ◽  
Intrapancreatic Accessory Spleen ◽  
Spleen Preserving ◽  
Technetium 99M ◽  
Radiological Features

Epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted with right upper quadrant abdominal pain. A cystic lesion in the pancreatic tail was discovered and evaluated by computed tomography and magnetic resonance images. Based on clinical and radiological features a solid pseudopapillary neoplasm was suspected. The patient underwent robot-assisted spleen preserving distal pancreatectomy. Pathological evaluation revealed a 26 mm intrapancreatic accessory spleen with a 16 mm cyst, lined by multilayered epithelium in the tail of the pancreas. The postoperative course was uneventful. Differentiating ECIPAS from (pre)malignant cystic pancreatic neoplasms based on clinical and radiological features remains difficult. When typical radiological signs can be combined with scintigraphy using Technetium-99m labelled colloid or Technetium-99m labelled erythrocytes, which can identify the solid component of the lesion as splenic tissue, it should be possible to make the right diagnosis noninvasively. When pancreatectomy is inevitable due to symptoms or patient preference, minimally invasive laparoscopic or robot-assisted spleen preserving distal pancreatectomy should be considered.

scholarly journals Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) with Preservation of Splenic Vessels: An Inferior-Posterior Approach

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yong Fei Hua ◽  
Dipesh Kumar Yadav ◽  
Xueli Bai ◽  
Tingbo Liang
Keyword(s):  
Blood Loss ◽  
Distal Pancreatectomy ◽  
Splenic Artery ◽  
Posterior Approach ◽  
Operative Time ◽  
The Other ◽  
Intraoperative Blood Loss ◽  
Spleen Preserving ◽  
Splenic Vessels ◽  
Approach Group

Objective. To summarize the operation experience of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with preservation of splenic vessels by an inferior-posterior dissection of the pancreatic body and evaluate its feasibility. Methods. Patients undergoing LSPDS at Ningbo Li Huili Hospital and Ningbo Li Huili Eastern Hospital from January 2014 to April 2017 were recruited in this study and were analyzed retrospectively. They were divided into two groups based on the surgical approach: the inferior-posterior approach group and the other approach group. We sought to compare outcomes of the two groups. Results. The LSPDP procedure was completed successfully in 49 cases, and 48 patients had their splenic artery and vein preserved, including 26 cases in the inferior-posterior approach group and 22 cases in the other approach group. There were no significant differences between the two groups with respect to age (p=0.18), sex (p=0.56), preoperative diabetes (p=1.00), ASA grading (p=1.00), tumor size (p=0.91), intraoperative blood loss (t=−0.01, p=0.99), hospital stay (t=−0.02, p=0.98), and pancreatic fistula rates (p=1.00). Patients undergoing LSPDP by the inferior-posterior approach had a shorter operative time (t=−4.13, p<0.001) than the other approach group. Conclusions. LSPDS by the inferior-posterior approach associated with shorter operative time is safe and feasible.

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