Misawa Takeyuki, Imazu Hiroo, Fujiwara Yuki, Kitamura Hiroaki, Tsutsui Nobuhiro, Ito Ryusuke, Shiba Hiroaki, Futagawa Yasuro, Wakiyama Shigeki, Ishida Yuichi, Yanaga Katsuhiko
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Asian J Endosc Surg. 2013 May;6(2):140-2. doi: 10.1111/ases.12006.
We report a patient who underwent laparoscopic enucleation for a nonfunctioning pancreatic neuroendocrine tumor. The patient was a 55-year-old man who had a 12- × 11-mm tumor close to the main pancreatic duct (MPD) in the pancreatic body. To avoid and detect injury to the main pancreatic duct during operation, a nasopancreatic drainage stent (NPDS) was endoscopically placed prior to the operation. According to the NPDS, the relation between the tumor and MPD was easily identified by laparoscopic ultrasonography during enucleation, thus enabling the resecting line to be determined. Moreover, after enucleation, pancreatography through the NPDS was able to clarify the absence of injury to the MPD. The NPDS was removed postoperatively, and the patient was discharged uneventfully on postoperative day 8. Preoperative placement of the NPDS seems to be a useful option for performing safe laparoscopic enucleation of pancreatic neuroendocrine tumor, especially when the lesion is located close to the MPD.
我们报告了一名接受腹腔镜摘除术治疗无功能性胰腺神经内分泌肿瘤的患者。该患者为一名55岁男性，胰腺体部有一个靠近主胰管（MPD）的12×11毫米肿瘤。为了避免并在手术中检测主胰管损伤，术前通过内镜放置了鼻胰引流支架（NPDS）。根据NPDS，在摘除肿瘤过程中通过腹腔镜超声很容易确定肿瘤与主胰管的关系，从而能够确定切除线。此外，摘除肿瘤后，通过NPDS进行的胰管造影能够明确主胰管无损伤。术后取出NPDS，患者于术后第8天顺利出院。术前放置NPDS似乎是安全进行胰腺神经内分泌肿瘤腹腔镜摘除术的一个有用选择，尤其是当病变靠近主胰管时。
