Medial Pancreatectomy for a Neuroendocrine Tumor Invading the Splenic Artery and Vein
Abstract
Context Pancreatic tumors in the midportion have traditionally been treated by an extended right or left pancreatectomy. A medial or central pancreatectomy is an alternative technique for benign or low-grade malignant neoplasms located to the left of the gastroduodenal artery and close to the splenomesenteric confluence. Case report A 38-year-old woman with no previous surgical history presented with epigastric abdominal pain. A computed tomography scan showed a 4 cm heterogeneous lesion within the pancreatic body. This tumor invaded the splenic artery and vein. There was no postoperative diabetes mellitus or exocrine insufficiency. The patient continues to be well after a 10-month follow-up without pancreatic insufficiency or local recurrence, and CT has demonstrated splenic perfusion by the collateral vessels. Conclusion We believe that a medial or central pancreatectomy may be a safe procedure where there is involvement of the large splenic vessels by a low grade malignant pancreatic tumor and that a systematic splenectomy is not justified.
Image: Proximal pancreas and jejunal Roux-en-Y pancreaticojejunostomy.
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References
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Copyright (c) 2010 Abdelmounaim Ait-Ali, Ibrahima Sall, Hakim El-Kaoui, Sidi Mohammed Bouchentouf, Abderrahmane El-Hjouji, Fadwa Rouibaa, Ahmed Benkirane, Ahmed Bounaim, Aziz Zentar, Khalid Sair
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