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Virgília GOMES

MD
Centro Hospitalar Universitário São João
Porto, Portugal
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Spleen-preserving total laparoscopic pancreatoduodenectomy
A 68-year-old woman was referred to us for multiple pancreatic cysts incidentally discovered on a routine ultrasound. An MRI was performed showing multiple cystic tumors throughout the pancreas, the largest of which was 15mm. This led to a suspicion of multifocal, side-branch intraductal papillary mucinous neoplasm (IPMN), with minimal dilatation of the main pancreatic duct. An echo-endoscopy was subsequently performed indicating the presence of a multifocal IPMN. A fine-needle aspiration (FNA) was performed during this procedure, with aspiration of cystic content which was sent for CEA analysis and cytology. Cytology was compatible with a mucinous neoplasm with mild atypia and CEA at 98 IU/mL.
A spleen-preserving total laparoscopic pancreatoduodenectomy was proposed. The procedure was uneventful and the patient was discharged on postoperative day 5. Pathology revealed a 19mm IPMN, with severe dysplasia and 3 foci of micro-invasive ductal adenocarcinoma of 1mm - pT1N0R0.
Surgical intervention
7 months ago
1045 views
9 likes
2 comments
07:41
Spleen-preserving total laparoscopic pancreatoduodenectomy
A 68-year-old woman was referred to us for multiple pancreatic cysts incidentally discovered on a routine ultrasound. An MRI was performed showing multiple cystic tumors throughout the pancreas, the largest of which was 15mm. This led to a suspicion of multifocal, side-branch intraductal papillary mucinous neoplasm (IPMN), with minimal dilatation of the main pancreatic duct. An echo-endoscopy was subsequently performed indicating the presence of a multifocal IPMN. A fine-needle aspiration (FNA) was performed during this procedure, with aspiration of cystic content which was sent for CEA analysis and cytology. Cytology was compatible with a mucinous neoplasm with mild atypia and CEA at 98 IU/mL.
A spleen-preserving total laparoscopic pancreatoduodenectomy was proposed. The procedure was uneventful and the patient was discharged on postoperative day 5. Pathology revealed a 19mm IPMN, with severe dysplasia and 3 foci of micro-invasive ductal adenocarcinoma of 1mm - pT1N0R0.