Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Surg Today. 2022 Apr;52(4):721-725. doi: 10.1007/s00595-021-02428-w. Epub 2021 Dec 1.
The perioperative management and technical details of laparoscopic clamp-crushing enucleation for low-malignant-potential pancreatic neuroendocrine neoplasms (PNENs) located close to the main pancreatic duct (MPD) in the body/tail of the pancreas using a perioperative MPD stent are reported. The procedure was performed in two patients with PNEN (13 and 10 mm in diameter) in the body/tail of the pancreas. A naso-pancreatic stent (NPS) was placed preoperatively in both patients. Resection was performed using Maryland-type bipolar forceps. The surgical duration was 139 and 55 min, and the estimated blood loss was 5 and 0 mL, respectively. One patient was discharged uneventfully on postoperative day (POD) 12. The other patient developed a grade B pancreatic fistula, but was discharged on POD 22. Laparoscopic clamp-crushing enucleation with an NPS might be a viable treatment option for tumors located close to the MPD.
报道了一种使用围手术期胰管支架的腹腔镜夹碎切除术治疗位于胰体尾部靠近主胰管（MPD）的低恶性潜能胰腺神经内分泌肿瘤（PNEN）的围手术期管理和技术细节。该手术在 2 例胰体尾部直径为 13 和 10 毫米的 PNEN 患者中进行。这 2 例患者均在术前放置了鼻胰管支架（NPS）。采用马里兰型双极钳进行切除。手术时间分别为 139 分钟和 55 分钟，估计出血量分别为 5 毫升和 0 毫升。1 例患者于术后第 12 天顺利出院。另 1 例患者发生 B 级胰瘘，但于术后第 22 天出院。对于靠近 MPD 的肿瘤，腹腔镜夹碎切除术联合 NPS 可能是一种可行的治疗选择。
