Medial pancreatectomy for a neuroendocrine tumor invading the splenic artery and vein
Ait-Ali, A.; Sall, I.; El-Kaoui, H.; Bouchentouf, S.M.; El-Hjouji, A.; Rouibaa, F.; Benkirane, A.; Bounaim, A.; Zentar, A.; Sair, K.
Jop Journal of the Pancreas 11(1): 75-77
2010
ISSN/ISBN: 1590-8577 PMID: 20065560 Document Number: 642070
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. 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. 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.