Ann Hepatobiliary Pancreat Surg.  2019 May;23(2):206-209. 10.14701/ahbps.2019.23.2.206.

Robotic assisted laparoscopic completion pancreatectomy for recurrent intraductal papillary mucinous neoplasm after previous open pancreatoduodenectomy: A case report and literature review

Affiliations
  • 1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. bsgkp@hotmail.com
  • 2Duke-NUS Medical School, Singapore.

Abstract

Completion pancreatectomy (CP), is an effective, and potentially curative option for selected patients with local recurrence of pancreatic neoplasms in the remnant pancreas after initial pancreatoduodenectomy (PD). Traditionally CP has been performed via the open approach. Reports of minimally-invasive CP particularly after previous open PD are rare. We present a case of a 72-year old male who previously underwent open PD 5 years ago for intraductal papillary mucinous neoplasm (IPMN) with high grade dysplasia in the uncinate process. He had multifocal IPMN and low-risk lesions in the body and tail were managed conservatively. On routine surveillance, the cyst in the body was noted to be increasing in size with the development of a non-enhancing solid component confirmed on magnetic resonance imaging and subsequent endoscopic ultrasonography. The patient underwent successful robotic assisted laparoscopic completion pancreatectomy. Final histology confirmed a recurrent IPMN with low-to-intermediate grade dysplasia. The postoperative recovery was uneventful and he was discharged on postoperative day 9.

Keyword

Completion pancreatectomy; Laparoscopic pancreatectomy; Robotic pancreatectomy; Minimally invasive pancreatectomy; Total remnant pancreatectomy

MeSH Terms

Endosonography
Humans
Magnetic Resonance Imaging
Male
Mucins*
Pancreas
Pancreatectomy*
Pancreatic Neoplasms
Pancreaticoduodenectomy*
Recurrence
Tail
Mucins

Figure

  • Fig. 1 Magnetic resonance of axial (A) and coronal image (B) demonstrating the worrisome-risk cystic neoplasm in the remnant pancreas with solid component.


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