Laparoscopic spleen-preserving pancreatic tail resection for an intrapancreatic accessory spleen mimicking a nonfunctioning endocrine tumor: report of a case

Surg Today. 2004;34(10):878-81. doi: 10.1007/s00595-004-2839-9.

Abstract

Laparoscopic surgery is now performed for several pancreatic disorders, such as benign tumors of the pancreatic body or tail, which are a good indication for laparoscopic resection. However, the risk of pancreatic fistula after distal pancreatectomy, performed laparoscopically or by open surgery, is a topic of debate. We report the case of a 61-year-old man in whom a routine follow-up computed tomography (CT) scan showed a solid, well-defined mass, 1.5 cm in diameter, in the pancreatic tail. The mass was homogeneously enhanced from the early phase to the super-delayed phase on enhanced CT. We suspected a nonfunctioning endocrine tumor of the pancreas, and surgery was performed laparoscopically. After dissecting the pancreatic tail away from the splenic hilum and the splenic vessels, it was resected using only a linear stapler. The histological diagnosis was an intrapancreatic accessory spleen. The patient was discharged on postoperative day 14, but was readmitted 6 days later because of a pancreatic fistula, which was treated by CT-guided percutaneous drainage.

Publication types

  • Case Reports

MeSH terms

  • Choristoma / diagnosis*
  • Choristoma / surgery*
  • Drainage
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Diseases / surgery*
  • Pancreatic Fistula / diagnostic imaging
  • Pancreatic Fistula / etiology
  • Pancreatic Fistula / surgery
  • Pancreatic Neoplasms / diagnosis
  • Spleen*
  • Surgical Stapling
  • Tomography, X-Ray Computed