PANCREATIC TUBE GUIDED INFERIOR PANCREATIC HEAD RESECTION FOR INTRADUCTAL PAPILLARY

概要

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Patients with intraductal papillary mucinous tumor (IPMT) have a good prognosis after surgical treatments. One of the recent advances in pancreatic surgery is organ preserving operation. Although local resection can preserve pancreatic function, morbidity still occurs frequently, especialy pancreatic fistula for the main pancreatic duct injury. We performed pancreatic tube guided inferior pancreatic head resection for branch typed IPMT. A 69-year-old man was admitted to the hospital because of epigastric pain. MRCP showed a cystic tumor about 3.5cm in diameter in the pancreatic head. Multiplanar reconstruction CT revealed the cystic tumor in the pancreatic uncus. Endoscopic retrograde pancreatography demonstrated the cystic tumor in the inferior pancreatic duct region. An endoscopic naso-pancreatic drainage (ENPD) tube was inserted in the main pancreatic duct on the preoperative day one. The resection line near the main pancreatic duct was decided by touching the ENPD tube. The patients, postoperative course was uneventful without postoperative complications. This procedure is considered to be appropriate for treating benign tumors and non-invasive malignant tumors involving the uncinate process.
日本臨床外科学会の論文