Hayasaki Aoi, Kuriyama Naohisa, Usui Miki, Nagata Motonori, Kaluba Benson, Sakamoto Tatsuya, Komatsubara Haruna, Maeda Koki, Shinkai Toru, Noguchi Daisuke, Ito Takahiro, Gyoten Kazuyuki, Fujii Takehiro, Iizawa Yusuke, Tanemura Akihiro, Murata Yasuhiro, Kishiwada Masashi, Mizuno Shugo
Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Mie University, Tsu, Mie, Japan.
Department of Oncologic Pathology, Mie University, Tsu, Mie, Japan.
Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70022. doi: 10.1111/ases.70022.
Annular pancreas is a rare congenital anatomical anomaly, in which the pancreatic parenchyma surrounds the descending duodenum. Generally, annular pancreas is diagnosed on the basis of symptoms associated with complications of peptic ulcer, pancreatitis, cholelithiasis, and rarely, malignant tumors. Herein, we report an 84-year-old man for whom, during hospitalization for a urinary tract infection, pancreatic cystic lesions and an annular pancreas were noted incidentally on computed tomography. These findings led to a diagnosis of intraductal papillary mucinous neoplasms on further examination. He safely underwent robot-assisted pylorus-preserving pancreatoduodenectomy, with an operative time of 478 min and blood loss of 37 g. He was discharged on postoperative day 8 without postoperative complications. In conclusion, it is important to note that, in this case, intraductal papillary mucinous neoplasms were detected before they became malignant, and minimally invasive surgery was performed safely despite the anatomical anomaly of an annular pancreas.
环状胰腺是一种罕见的先天性解剖异常，其中胰腺实质围绕十二指肠降部。一般来说，环状胰腺是根据与消化性溃疡、胰腺炎、胆石症并发症相关的症状诊断的，很少根据恶性肿瘤诊断。在此，我们报告一名84岁男性，他因尿路感染住院期间，在计算机断层扫描中偶然发现胰腺囊性病变和环状胰腺。这些发现经进一步检查后诊断为导管内乳头状黏液性肿瘤。他安全地接受了机器人辅助保留幽门的胰十二指肠切除术，手术时间为478分钟，失血37克。他在术后第8天出院，无术后并发症。总之，需要注意的是，在本病例中，导管内乳头状黏液性肿瘤在恶变前被检测到，尽管存在环状胰腺的解剖异常，但仍安全地进行了微创手术。
