We present a case report that demonstrates diagnostic and intraoperative challenges in the laparoscopic management of initially unrecognized splenic hydatid disease. A male patient, aged 44, was admitted to our department with a big unilocular splenic cyst, radiologically (ultrasonography, computed tomography) characterized as a simple cyst. Serological tests for anti-Echonococcus antibody were negative, and chests X-ray findings were unremarkable, so laparoscopic cyst fenestration with omentoplasty was planned. The intraoperative finding did not correspond to a simple splenic cyst. Hydatid daughter cysts were recognized after the careful opening of the cyst wall. The operation was completed without shifting to open procedures. Laparoscopic partial pericystectomy with omentoplasty is a safe and effective surgical procedure for the management of splenic hydatid disease.

Introduction Frantz's tumor of the pancreas is a rare phenomenon, and it accounts for 1–3% of all neoplasms of the pancreas. Its percentage is much higher in younger persons, especially in younger women, as compared to the rest of the population. Presentation of case The present study describes a 32-year-old female patient in whom a preoperative imaging diagnosis confirmed a mass in the junction of the pancreas' body and tail. Based on the anamnesis, the preoperative diagnosis, and the patient's general status, the decision was made to performed laparoscopic enucleation of the pancreatic tumor. The operation and postoperative recovery passed without complications. Definitive histopathological and immunohistochemical findings confirmed a solid pseudopapillary neoplasm of the pancreas. Discussion Depending on the localization and the size of the tumor, surgical options range from typical and atypical resections of the pancreas to minimally invasive surgical procedures, such as local excision and enucleation. Laparoscopic procedures have a comparative advantage in cases of enucleation and resection of the pancreas. The low frequency of recidivation and a favorable prognosis, even after repeated surgery, are additional reasons for favoring the laparoscopic approach over the classical surgical approach. Conclusion A minimally invasive surgical approach should be applied whenever the dimensions and the localization of the tumor permit it, bearing in mind all the benefits and advantages that this surgical technique offers.

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Analysis of the surgical treatment of the patients operated on by using laparoscopic and classic splenectomy due to benign disorders of the spleen.

Introduction/Objective Splenic cysts are a rare clinical entity. In their origin, they may be parasitic or non-parasitic. They are classified as either primary (true) or secondary cysts (pseudocysts), depending on the presence or absence of an epithelial lining of the lumen. Methods Using a retrospective case study, we included 29 patients undergoing laparoscopic surgery due to splenic cysts. The patients were treated within the 2007-2017 period at the Clinic for Digestive Surgery, the Clinical Center of Serbia. We analyzed pre-operative, intra-operative and post-operative characteristics of laparoscopic technique in treating non-parasitic splenic cysts. Results The group of 29 patients treated with laparoscopic technique surgery due to the previously diagnosed splenic cyst, consisted of 12 (41.4%) men and 17 (58.6%) women. The average age of patients undergoing surgery was 38.86 ± 10.4 years (22-62). Based on the histopathological findings, there were eight epithelial cysts and 21 pseudocysts of the spleen. The maximal diameter of the splenic cyst, measured pre-operatively, was 10.09 ± 2.51 cm on average. The average operative time was 35 minutes, and the intra-operative bleeding amount was 11.48 ± 3.78 ml. None of the intra-operative complications, injury to the spleen or other organs of the abdomen, conversions to open surgery or reintervention were recorded. Conclusion Laparoscopic fenestration with excision of the part of the spleen cyst wall (marsupialization) represents an effective and definitive treatment for this disease. It is an alternative to splenectomy, along with other well-known benefits ensured by the spleen preservation. Low probability of occurrence of intra-operative and post-operative complications, as well as minimal trauma of tissue, results in a shorter postoperative stay, rapid recovery, and better quality of life.