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J Minim Access Surg. 2019 Jan 4. doi: 10.4103/jmas.JMAS_150_18. [Epub ahead of print]

Laparoscopic splenic vessels and spleen-preserving extended distal pancreatectomy for single metastatic renal cell carcinoma.

Author information

1
Department of Surgery, Bankstown-Lidcombe Hospital, University of New South Wales, Bankstown, NSW, Australia.

Abstract

Laparoscopic splenic vessels and spleen-preserving (SVSP) distal pancreatectomy has been recommended to reduce long-term risk of developing infectious complications. Due to its technical challenge, most cases relate to <50% of the pancreatic gland being excised. We present our first case of a patient incidentally found to have a solitary pancreatic metastatic renal cell carcinoma (RCC), following left nephrectomy for kidney cancer 15 years ago. He underwent laparoscopic SVSP-extended distal pancreatectomy (EDP). Final histopathology confirmed the diagnosis and margins were clear. He made a good recovery and despite loosing >70% of his pancreas, hasn't developed new-onset diabetes. No adjuvant chemotherapy was necessary, but he will require long-term follow-up. This case suggests that even when the pancreatic lesion is located more proximally, near or at the pancreatic neck, laparoscopic SVSP-EDP may still be considered a safe and preferable option despite its greater complexity, increased intraoperative bleeding risk and longer operative time.

KEYWORDS:

Extended distal pancreatectomy; laparoscopic; metastatic renal cell carcinoma; splenic vessels spleen-preserving

PMID:
30618418
DOI:
10.4103/jmas.JMAS_150_18
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