Laparoscopic Central Pancreatectomy and Pancreaticogastrostomy for the Management of a Proximally Migrated Pancreatic Stent

Felipe Gonzalez; Marc G Mesleh; Frank J Lukens; Michael B Wallace; Horacio J Asbun; John Andrew Stauffer

doi:10.6092/1590-8577/1412

Felipe Gonzalez Department of General Surgery, Mayo Clinic. Jacksonville, FL, USA
Marc G Mesleh Department of General Surgery, Mayo Clinic. Jacksonville, FL, USA
Frank J Lukens Division of Gastroenterology and Hepatology, Mayo Clinic. Jacksonville, FL, USA
Michael B Wallace Division of Gastroenterology and Hepatology, Mayo Clinic. Jacksonville, FL, USA
Horacio J Asbun Department of General Surgery, Mayo Clinic. Jacksonville, FL, USA
John Andrew Stauffer Department of General Surgery, Mayo Clinic. Jacksonville, FL, USA

DOI: https://doi.org/10.6092/1590-8577/1412

Keywords: Laparoscopy, Pancreas, Pancreatectomy, Stents

Abstract

Context Pancreatic stents are used for both benign and malignant pancreatic disease but can be associated with complications such as proximal migration. Case report A 43-year-old female with benign biliary disease underwent prophylactic pancreatic stent placement after endoscopic retrograde cholangiopancreatography. This stent migrated proximally into the pancreatic duct and could not be retrieved by endoscopic measures. Therefore, she underwent surgical retrieval via a laparoscopic central pancreatectomy with pancreaticogastrostomy reconstruction. The procedure took 250 minutes with minimal blood loss. The postoperative course was uneventful and the patient was discharged on the sixth postoperative day without any evidence of pancreatic fistula. Conclusion Laparoscopic central pancreatectomy is a feasible option for the unusual indication of a retained proximally migrated pancreatic duct stent.

Image: Pancreatic ductotomy with exposure of the impacted 5 Fr pigtail pancreatic duct stent.

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Author Biography

John Andrew Stauffer, Department of General Surgery, Mayo Clinic. Jacksonville, FL, USA

Assistant Professor

Department of General Surgery

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