Laparoscopic Spleen Preserving Distal Pancreatectomy for Solid Pseudopapillary Neoplasm of The Pancreas

Koray Karabulut, MD¹, Mehmet Ruhi Onur, MD², Ibrahim Hanifi Ozercan, MD³, Kenan Binnetoglu, MD¹, Leyla Kilic, MD⁴. ¹Firat University School of Medicine General Surgery Department, ²Firat University School of Medicine Radiology Department, ³Firat University School of Medicine Pathology Department, ⁴Firat University School of Medicine Medical Oncology Department

This video presents the case of a surgical procedure performed in a 16-year old girl presenting with a huge mass in the tail of pancreas. The patient complained of abdominal pain. The computed tomography scan demonstrated a 10 cm lesion, including both solid and cystic areas and calcification. Tumor markers were normal. Preoperative diagnosis was solid pseudopapillary neoplasm of pancreas. Any infiltration to spleen, splenic artery or vein was not observed. Considering the radiologic findings a spleen preserving distal pancreatectomy is decided. Following the division of the gastrocolic ligament, the splenic vessels were isolated along the inferior and superior borders of the pancreas and dissected free from their pancreatic vascular branches. Once the body and the tail of the pancreas were completely freed, a distal pancreatectomy was performed by means of a stapler. The postoperative period was uneventful. Final histology confirmed the preoperative diagnosis. Solid pseudopapillary neoplasm of the pancreas is a rare neoplasm. It can be treated by complete tumor resection with a minimally invasive approach.