Spleen-preserving distal pancreatectomy in the management of solid papillary-cystic tumor of the pancreas: case report and literature review

Soares-Junior, Cleber; Gomes, Carlos Augusto; Peixoto, Rodrigo de Oliveira; Gomes, Camila Couto; Juste, Luciano Augusto

doi:10.1590/s0102-67202010000300015

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…Although the number of laparoscopic pancreatectomies for SPT is still small, the indication has increased markedly in the past years. 10,16,21 Distal pancreatectomy is the most commonly performed laparoscopic pancreatic resection, because there is no need for manual anastomosis or complex reconstruction of the digestive tract. Several authors have demonstrated that laparoscopic distal pancreatectomy has several advantages, such as reduction of postoperative pain and analgesic requirements, wound complications, blood loss, operative time, and hospital stay compared with open distal pancreatectomy.…”

Section: Discussionmentioning

confidence: 99%

“…24,25 Spleen-preserving laparoscopic distal pancreatectomy is indicated for benign or low-grade malignant tumors, such as SPT, located in the body or tail of the pancreas. 21 The most important technical aspect of this procedure is to safely separate body and tail pancreatic parenchyma from splenic vessels. This may be easier to perform through laparoscopy than open surgery.…”

Section: Discussionmentioning

confidence: 99%

“…An increasing number of authors perform distal pancreatectomy routinely with lower morbidity and mortality than open resection. 16,17,21 However, the advantages of the more complex pancreatoduodenectomy or central pancreatectomy through laparoscopy have not been determined. Only a very small number of surgeons perform these procedures routinely.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Coelho

Costa

Ramos

et al. 2018

JSLS

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Background and Objectives:Although solid pseudopapillary tumor (SPT) of the pancreas is rare, its diagnosis has increased severalfold in the past decades. We present our experience in the management of SPT, including a patient who experienced tumor rupture during laparoscopy pancreatic resection.Methods:Data on all patients with SPT who were subjected to surgical treatment were retrospectively obtained.Results:Of 20 patients evaluated, 17 (85%) were females. The mean age was 31 years. Tumor size varied from 2.7 × 1.5 to 13.5 × 10.0 cm, with a mean of 6.4 × 7.6 cm. The most common location was the tail and/or body of the pancreas (14 patients [70%]). Pancreatic tumor resection was performed in 19 patients (50%). The type of resection depended on tumor location and size: distal pancreatectomy (n = 13), pancreatoduodenectomy (n = 5), and central pancreatectomy (n = 1) Pancreatic resection was performed via laparoscopy in 7 patients who underwent distal pancreatectomy. Tumor resection was not performed in only 1 patient (5%), due to invasion of mesenteric vessels and presence of liver metastases. One patient had tumor rupture during laparoscopic resection, with no apparent macroscopic dissemination of the tumor. All 19 patients who underwent SPT resection had no tumor recurrence, including a patient with capsule invasion and another patient with tumor rupture during surgical dissection. The mean follow-up time was 38 months (range, 6–72 months).Conclusion:Complete SPT resection is possible in most patients, with a low recurrence rate. Because of its large size, laparoscopic resection of SPT's should be performed only by experienced surgeons to avoid tumor rupture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Coelho

Costa

Ramos

et al. 2018

JSLS

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“…Although this technique has not shown superiority over the Retrograde Pancreatosplenectomy standard in terms of survival rate and recurrence-free survival, it allows to achieve high rates of a negative margin and resected metastatic lymph nodes [15,16]. Laparoscopic pancreatectomies for SPN frequency remains low, even if the procedure is considered relatively simple given that it does not require complex reconstructions of the digestive tract or anastomosis [3,17,18]. A series of studies have demonstrated the benefit of laparoscopic distal pancreatectomy over laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Solid Pseudopapillary Tumor of the Pancreas with Node Invasion: What to do? A Case Report and Literature Review

Sekkat¹,

Moufid²,

Nadouri³

et al. 2022

austinjsurg

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Solid Pseudopapillary Neoplasms (SPN) of the pancreas are rare neoplasms representing 1-2% of all pancreatic tumors, and considered as low-grade malignancies. This pathology mainly affects young women. Its prognosis is usually excellent when the tumor is limited to the pancreas, with a cure rate greater than 95% after a complete surgical resection. Preoperative diagnosis is always difficult. SPNs can be metastatic. Hepatic and lymph node localizations are the most reported in the literature. The recurrence rate after surgical resection is 3-9%. We report the case of a 36-year-old patient who was complaining of abdominal pain for 2 months. An abdominal contrast-enhanced Computed Tomography (CT) scan showed a solido-cystic mass of the tail of the pancreas. The patient underwent laparoscopic radical antegrade modular pancreatosplenectomy. The diagnosis of SPN with lymph node metastasis was confirmed by histopathology and immunohistochemistry, requiring adjuvant chemotherapy.

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“…In addition, even today surgical treatment is still associated with significant morbidity and mortality 6 . When analyzing the Brazilian national scenario, there are only few studies on the subject, usually based on case reports 7 , already operated case series 8 , 9 , or case series submitted to some specific exam and no appropriate clinical or radiological follow-up 10 . The objective of this study was to evaluate a consecutive series of patients seeking the clinic of digestive tract diseases with pancreatic cyst, whose diagnosis of pseudocyst was ruled out and the one of pancreatic cystic neoplasia (PCN) was most likely.…”

Section: Introductionmentioning

confidence: 99%

Non-inflammatory pancreatic cysts: from diagnosis to treatment (97 cases series)

Amico

Salgado

Alves

et al. 2021

Rev. Col. Bras. Cir.

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Objective: to describe the implications of the diagnosis and treatment of non-inflammatory pancreatic cysts in a series of patients. Methods: we included patients with pancreatic cysts ≥1.0 cm, excluding those with a presumptive diagnosis of a pseudocyst. Imaging tests, echoendoscopy, and histopathology determined the diagnosis of the type of cyst. We applied the guidelines of the International Association of Pancreatology, with some modifications, in patients with mucinous or indeterminate lesions. Results: 97 adult patients participated in the study. A cystic neoplasm of the pancreas was diagnosed in 82.5% of cases. Diagnosis was mainly made by magnetic resonance (46% of cases). The two most common diagnoses were intraductal papillary mucinous neoplasm (43.3%) and serous cystadenoma (26%). Twenty-nine patients underwent surgery (33.3%). The most common surgical procedure was distal pancreatectomy associated with splenectomy in 19 cases (65.5%). Among the operated patients, 11 were diagnosed with cancer. None of the followed, non-operated patients had a diagnosis of cancer. Conclusions: magnetic resonance showed good accuracy, particularly in the diagnosis of intraductal papillary mucinous neoplasm. The guidelines of the International Association of Pancreatology, as applied in this study, showed a negative predictive value for cancer of 100%. A development of better diagnostic tests can reduce the number of unnecessary operations.

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Spleen-preserving distal pancreatectomy in the management of solid papillary-cystic tumor of the pancreas: case report and literature review

Cited by 3 publications

References 11 publications

Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Surgical Management of Solid Pseudopapillary Tumor of the Pancreas

Solid Pseudopapillary Tumor of the Pancreas with Node Invasion: What to do? A Case Report and Literature Review

Non-inflammatory pancreatic cysts: from diagnosis to treatment (97 cases series)

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