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Subtotal laparoscopic pancreatectomy for the treatment of hyperinsulinism in a 12-year-old girl
We present the case of a 12-year-old girl who presented with symptoms of dizziness and weakness for 4 months. Hyperinsulinemic hypoglycemia was found. Pancreatic PET-scan and CT-scan showed no focal lesions and a slightly increased volume of the pancreatic tail. After selective calcium stimulation of the pancreas, increased insulin was found from the body and tail. Laparoscopic pancreatectomy was scheduled. Failure with prednisone treatment indicated laparoscopic subtotal pancreatectomy.
Surgery was carried out using a four-trocar technique. The pancreas was approached through the greater omentum. Careful dissection of the small pancreatic vessels coming from the splenic vessels is performed. A subtotal pancreatectomy near the duodenum was carried out by means of the Endo-GIA® linear stapler in the head and ultrasonic scalpel and hook in the body and tail. Drainage was left in situ.
E Bracho, E Fernàndez, C Zalles
Surgical intervention
7 years ago
1835 views
10 likes
0 comments
09:00
Subtotal laparoscopic pancreatectomy for the treatment of hyperinsulinism in a 12-year-old girl
We present the case of a 12-year-old girl who presented with symptoms of dizziness and weakness for 4 months. Hyperinsulinemic hypoglycemia was found. Pancreatic PET-scan and CT-scan showed no focal lesions and a slightly increased volume of the pancreatic tail. After selective calcium stimulation of the pancreas, increased insulin was found from the body and tail. Laparoscopic pancreatectomy was scheduled. Failure with prednisone treatment indicated laparoscopic subtotal pancreatectomy.
Surgery was carried out using a four-trocar technique. The pancreas was approached through the greater omentum. Careful dissection of the small pancreatic vessels coming from the splenic vessels is performed. A subtotal pancreatectomy near the duodenum was carried out by means of the Endo-GIA® linear stapler in the head and ultrasonic scalpel and hook in the body and tail. Drainage was left in situ.
Totally laparoscopic duodenal pancreatectomy for cancer
Since the early 1990s, laparoscopic techniques have been applied to a growing number of pancreatic surgeries. Laparoscopic pancreatic resections have been performed in patients with a variety of diseases including chronic pancreatitis, pancreatic trauma, congenital hyperinsulinism. Laparoscopic proximal pancreatectomies for cancer with or without duodenum preservation remain controversial. Although a laparoscopic pancreaticoduodenectomy is technically feasible, laparoscopic reconstruction after proximal pancreatectomies is not yet generally practicable but limited to personal experiences of highly skilled surgeons.
This interesting video shows all steps and landmarks of a totally laparoscopic duodenopancreatectomy for cancer performed by a very experienced surgeon.
F Corcione, J Marescaux
Surgical intervention
10 years ago
8789 views
36 likes
0 comments
21:13
Totally laparoscopic duodenal pancreatectomy for cancer
Since the early 1990s, laparoscopic techniques have been applied to a growing number of pancreatic surgeries. Laparoscopic pancreatic resections have been performed in patients with a variety of diseases including chronic pancreatitis, pancreatic trauma, congenital hyperinsulinism. Laparoscopic proximal pancreatectomies for cancer with or without duodenum preservation remain controversial. Although a laparoscopic pancreaticoduodenectomy is technically feasible, laparoscopic reconstruction after proximal pancreatectomies is not yet generally practicable but limited to personal experiences of highly skilled surgeons.
This interesting video shows all steps and landmarks of a totally laparoscopic duodenopancreatectomy for cancer performed by a very experienced surgeon.