No abstract available.
Pancreatectomy* ; Spleen*

No abstract available.
Humans ; Hypoglycemia ; Infant ; Pancreatectomy

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas has been recently reported. It is very rare, therefore clinical behavior and prognosis has not yet been characterized. We experienced a case of ITPN of the pancreas which presented with acute pancreatitis and treated with Whipple's operation. Histopathologic finding showed papillary hyperplasia with carcinomatous change. The tumor recurred after 47 month of operation, and she underwent total pancreatectomy. Pathologic finding revealed tubulopapillary growth with high grade dysplasia. Immunohistochemial staining was not performed, however gross and microscopic findings were compatible with ITPN of the pancreas. We report a case of ITPN of the pancreas.
Hyperplasia ; Pancreas* ; Pancreatectomy ; Pancreatitis* ; Prognosis

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas has been recently reported. It is very rare, therefore clinical behavior and prognosis has not yet been characterized. We experienced a case of ITPN of the pancreas which presented with acute pancreatitis and treated with Whipple's operation. Histopathologic finding showed papillary hyperplasia with carcinomatous change. The tumor recurred after 47 month of operation, and she underwent total pancreatectomy. Pathologic finding revealed tubulopapillary growth with high grade dysplasia. Immunohistochemial staining was not performed, however gross and microscopic findings were compatible with ITPN of the pancreas. We report a case of ITPN of the pancreas.
Hyperplasia ; Pancreas* ; Pancreatectomy ; Pancreatitis* ; Prognosis

Cystic lesions in the accessory spleen are extremely rare and they present a challenging clinical differential diagnosis. We report here on two cases of epithelial cyst of intrapancreatic accessory spleen that mimicked pancreatic cystic tumor. In both cases, the patients underwent distal pancreatectomy under the impression of a benign cystic tumor of the pancreas. Unilocular or multilocular cysts in the pancreas tail were observed, and these were later shown to be epithelial cysts in the accessory spleen located within the pancreatic tail. The cysts were lined by columnar, cuboidal or stratified squamous epithelium.
Diagnosis, Differential ; Epithelium ; Humans ; Pancreas ; Pancreatectomy ; Pancreatic Cyst* ; Spleen*

In spite of lack of randomized control study, laparoscopic distal pancreatectomy (DP) is regarded as appropriate treatment in managing benign and low grade malignant tumor in distal part of the pancreas. With the advance of laparoscopic skills, innovative instruments, and perioperative management, clinical effort to reduce the access injury for laparoscopic DP has been attempted to enhance the cosmetic effect and the benefit of minimally invasive surgery. Due to inborn technical limitation of laparoscopic surgical system, it is not easy to perform laparoscopic reduced port-or single port-distal pancreatectomy (LRP/LSP-DP) in daily routine clinical practice, however, surgical technique for safe and effective LRP/LSP-DP has been developed. Till now, only a few experts reported the technical feasibility and safety of LRP/LSP-DP in selected patients. According to literature review, the number of the patients who underwent LRP/LSP-DP seems to gradually increase. In this moment, surgical experiences may be too limited to reach the conclusion, but, with the help of robotic surgical system, LRP/LSP-DP has potential room for further investigation. Therefore, minimally invasive surgeons need to pay attention to this innovative movement. In this review, currently available surgical techniques for LRP/LSP-DP has been summarized with some future perspectives on this technique.
Humans ; Minimally Invasive Surgical Procedures ; Pancreas ; Pancreatectomy* ; Surgeons

PURPOSE: Despite recent advances in laparoscopic pancreatic surgery, few studies have compared laparoscopic central pancreatectomy (LCP) with open central pancreatectomy (OCP). The aim of this study was to compare clinical outcomes between LCP and OCP as a single institutional study. METHODS: During the study period (From January, 1998 to December, 2010), we performed central pancreatectomy in 95 cases. Among them, 26 cases of totally LCP and 55 cases of OCP were compared retrospectively. RESULTS: Benign pancreatic neoplasm was the main indication. The mean operation time for the LCP group (350.2 min) was longer than that for the OCP group (283.4 min). And there was no significant difference in mean actual blood loss (477 ml versus 714 ml, p=0.083) between the LCP and OCP groups. Return to a normal bowel movement and resumption of a liquid diet were achieved 5.5+/-2.6 days after the operation in the LCP group and 6.6+/-2.0 days after the operation in the OCP group (p=0.039). The mean duration of postoperative hospital stay was 13.8 days for the LCP group, which was significantly shorter than the 22.5 days for the OCP group (p=0.015). The overall complication rate was 42.3% (11 cases) in the LCP group and 45.5% (25 cases) in the OCP group (p=0.790). CONCLUSION: Use of LCP for benign or low grade malignant lesions of the pancreatic neck portion is feasible and safe. Compared to the open method, the laparoscopic approach to central pancreatectomy appears to provide advantages of early resumption of a normal diet and reduction of postoperative hospital stay without further complications.
Diet ; Laparoscopy ; Length of Stay ; Neck ; Pancreatectomy ; Pancreatic Fistula ; Pancreatic Neoplasms

Pancreatic arteriovenous malformation (AVM) is an extremely rare condition with various clinical manifestations. We report herein a case of recurrent acute pancreatitis due to pancreatic AVM in a 49-year-old man. This patient presented with epigastric pain that had developed after consuming alcohol 2 days prior to admission. Serum amylase and lipase levels were elevated and computed tomography revealed focal low-attenuation lesions with peripancreatic infiltrations in the pancreatic tail and multiple collateral vessels around the low-attenuation lesions. He was diagnosed with acute pancreatitis and pancreatic AVM. Although he had stopped drinking after the first attack of acute pancreatitis, his pancreatitis recurred twice within 3 months. He underwent a distal pancreatectomy after the third attack of acute pancreatitis. He was free of symptoms for 2 years after the pancreatectomy.
Amylases ; Arteriovenous Malformations ; Drinking ; Humans ; Lipase ; Middle Aged ; Pancreatectomy ; Pancreatitis

PURPOSE: The consumers' preferences are not considered in developing or implementing new medical technologies. Furthermore, little efforts are made to investigate their demands. Therefore, their preferred surgical method and the factors affecting that preference were investigated in pancreatic surgery. METHODS: Six-hundred subjects including 100 medical personnel (MP) and 500 lay persons (LP) were surveyed. Questionnaire included basic information on different methods of distal pancreatectomy; open surgery (OS), laparoscopic surgery (LS), and robotic surgery (RS). Assuming they required the operation, participants were told to indicate their preferred method along with a reason and an acceptable cost for both benign and malignant conditions. RESULTS: For benign disease, the most preferred method was LS. Limiting the choice to LS and RS, LS was preferred for cost and well-established safety and efficacy. OS was favored in malignant disease for the concern for radicality. Limiting the choice to LS and RS, LS was favored for its better-established safety and efficacy. The majority thought that LS and RS were both overpriced. Comparing MP and LP responses, both groups preferred LS in benign and OS in malignant conditions. However, LP more than MP tended to prefer RS under both benign and malignant conditions. LP thought that LS was expensive whereas MP thought the cost reasonable. Both groups felt that RS was too expensive. CONCLUSION: Though efforts for development of novel techniques and broadening indication should be encouraged, still more investments and research should focus on LS and OS to provide optimal management and satisfaction to the patients.
Consumer Satisfaction ; Humans ; Investments ; Laparoscopy ; Methods ; Pancreas ; Pancreatectomy ; Surveys and Questionnaires

PURPOSE: Pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) are treatments used for pancreatic benign neoplasms even though both of these treatments result in significant loss of normal pancreatic parenchyma; this leads to subsequent impairment of exocrine and endocrine pancreatic function. The purpose of this study is to provide short-and long-term result of limited resection (LR) in a single center. METHODS: Two-hundred thirty patients who had undergone pancreatic resection between April 1998 and September 2008 for benign neoplasms were reviewed retrospectively. DP was performed in 102 patients, LR in 77, PD in 51 patients. The definitions of the International Study Group of Pancreatic Fistula (ISGPF) were applied to postoperative pancreatic fistulas (POPF), perioperative endocrine function was evaluated through oral glucose tolerance test. RESULTS: LR includes 42 enucleation, 24 central pancreatectomy, and 11 uncinate process resection. No deaths occurred to patients during the study review period; POPF was detected in 50 patients (65%), 37 patients with grade A and 13 patients with grade B or C. POPF occurred 65% of the time after LR, more frequently compared to the occurrance after PD or DP (58%), but this was not statistically significant (P =.322). After LR, there were 2 patients with new onset diabetes (3%), while 26 (17%) patients developed diabetes after DP or PD (P = .002). CONCLUSION: LR may preserve endocrine and exocrine function. While mortality is low with the use of LR, it is associated with a higher pancreatic-leakage rate. The precise management of benign pancreatic lesions remains in evolution.
Glucose Tolerance Test ; Humans ; Pancreatectomy ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Retrospective Studies