Laparoscopic distal splenopancreatectomy for pancreatic cystadenoma: clockwise technique assisted with T’Lift device
Epublication WebSurg.com, Jan 2019;19(01). URL: http://websurg.com/doi/vd01en5535
Serous cystic neoplasm is a cystic neoplasm of the pancreas, which is increasingly detected at an asymptomatic stage. Serous cystadenomas are benign cystic tumors which occur more often in women than in men, and particularly in the seventh decade of life. Despite this, in the literature, three patients were reported to have malignant serous cystadenomas, with sizes greater than 7cm. The serous cystic neoplasm was confirmed by an imaging characteristic appearance, with multiple small or different-sized cysts, but when the diagnosis is doubtful, which often leads to surgery. The clinical case is the one of a 79-year-old woman with a cystadenoma of the pancreas. She had a history of partial cystectomy for bladder neoplasia and recently (in 2017), she was submitted to laparoscopic focal cryotherapy for the treatment of a left unilateral renal tumor. At that time, she underwent a CT-can, which found a cystic neoplasm of the tail of the pancreas. A heterogeneous 5cm lesion appeared in the left hypochondrium, near the lower pole of the spleen, with no evidence of adenopathies highly suggestive of a serous cystadenoma of the pancreas. In October 2018, in a follow-up CT-scan, there was an increase in size of the lesion (6.6cm) and a surgical resection was planned. A distal splenopancreatectomy using a clockwise technique was performed using the Signia™ stapling system with no complications. Histological examination confirmed a serous cystadenoma of the pancreas.