Pacilio Carlo Alberto, Cavaliere Davide, Ercolani Giorgio
General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy.
Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
J Gastrointest Surg. 2023 May;27(5):1042-1044. doi: 10.1007/s11605-023-05620-0. Epub 2023 Feb 27.
The inframesocolic approach to the uncinate process of the pancreas has been rarely described in literature. To the best of our knowledge, no robotic cases have been reported.
The case of a 74-year-old woman, with a 43-mm branch-duct intraductal papillary mucinous neoplasm with worrisome features within the uncinate process of the pancreas, is described.
After diagnostic work-up, due to the uncertain potential of malignancy and the strong motivation of the patient to undergo surgery, we performed a robotic enucleation through an inframesocolic approach. The neoplasm was more than 1 cm from the main pancreatic duct. Final pathological diagnosis revealed a low-grade dysplasia branch-duct intraductal papillary mucinous neoplasm.
The inframesocolic approach could represent an easy way to access the uncinate process of the pancreas, allowing safe limited resection in selected cases such as small branch-duct IPMN or pancreatic neuroendocrine tumors.
胰腺钩突的结肠下入路在文献中鲜有描述。据我们所知，尚无机器人手术病例的报道。
描述了一名74岁女性的病例，其胰腺钩突内有一个43毫米的分支导管内乳头状黏液性肿瘤，具有令人担忧的特征。
经过诊断评估，由于恶性潜能不确定且患者强烈希望接受手术，我们通过结肠下入路进行了机器人摘除术。肿瘤距主胰管超过1厘米。最终病理诊断为低级别异型增生性分支导管内乳头状黏液性肿瘤。
结肠下入路可能是一种进入胰腺钩突的简便方法，在某些特定病例中，如小分支导管内乳头状黏液性肿瘤或胰腺神经内分泌肿瘤，可实现安全的局限性切除。
