Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
Warwick Medical School, University of Warwick, Coventry, West Midlands, UK.
BMJ Case Rep. 2020 Aug 24;13(8):e234887. doi: 10.1136/bcr-2020-234887.
A 62-year-old man was referred to the Hepato-Pancreato-Biliary (HPB) surgeons with left upper quadrant discomfort. The initial investigations and CT scans revealed a tumour in the pancreatic tail with liver metastases, confirmed on MRI. It was initially thought to be an adenocarcinoma; however, further investigations found that it was a grade 1 neuroendocrine tumour with Ki 67 at 1% and it was agreed that he would undergo a total robotic surgery involving resection of the locally advanced tumour of the tail of pancreas, with the involvement of the stomach, and splenic flexure of the colon with liver metastases. The resulting procedure was a total robotic distal pancreatectomy, splenectomy, sleeve resection of stomach, cholecystectomy, atypical resection of two liver lesions and microwave ablation of multiple liver lesions. Four days post-operatively, he was discharged from hospital and commenced adjuvant chemotherapy. He currently enjoys a good quality of life.
一位 62 岁男性因左上腹不适就诊于肝胆胰外科医生。初步检查和 CT 扫描显示胰腺尾部有肿瘤，MRI 证实存在肝转移。最初认为是腺癌；然而，进一步的检查发现这是一个 1 级神经内分泌肿瘤，Ki67 为 1%，因此决定对其进行全机器人手术，包括切除胰腺尾部局部晚期肿瘤，胃和结肠脾曲受累以及肝转移灶。手术方式为全机器人胰体尾切除术、脾切除术、胃袖状切除术、胆囊切除术、两个肝转移灶的非典型切除术和多个肝转移灶的微波消融术。术后 4 天，患者出院并开始接受辅助化疗。目前，他生活质量良好。
