Middle-segment preserving pancreatectomy for multifocal neuroendocrine pancreatic tumors.

摘要: Abstract Background Multifocal neuroendocrine tumors (NET) usually occur in the context of a multiple neoplasia type 1 (MEN1). When proximal part pancreatic body is spared by NET, Miura et al. have proposed “middle-segment preserving” pancreatectomy (MSP) as alternative to total [ [1] , [2] [3] ]. Video A 28-year-old woman with MEN1 was referred for surgical resection multifocal tumor single metastasis located and liver close contact left hepatic duct. The preoperative work-up DOTATOC-PETSCAN revealed sparing only body. Hormonal dosages were normal but Chromogranine elevated at 700 μg/l. At surgery intraoperative ultrasonography confirmed absence pancreas. pancreaticoduodenectomy performed first followed partial splenectomy. 3 × 5 cm remnant vascularized dorsal artery preserved ( Fig. ). hepatectomy then 2 Digestive reconstruction pancreatojejunostomy an externalized stent 3 ), hepaticojejunostomy gastrojejunal anastomosis. Results Surgery lasted 660 minutes. Postoperative course uneventful late readmission necessary because pyelonephritis due nephrolithiasis treated ureteral insertion. 11 months postoperative follow-up patient disease-free no endocrine dysfunction under oral enzyme supplementation. Total weight loss since 8 Kilograms. Conclusions middle-segment-preserving could be valid This operation can achieve acceptable functional outcomes large series long-term follow up are needed evaluate advantages results MSP.