Work

Laparoscopic Transection of the Pancreatic Neck With Enucleation of Intraductal Papillary Mucinous Neoplasm (IPMN) in the Uncinate Process and Pancreatic Reconstruction

Year: 2025

Type: article

Abstract: BACKGROUND: Laparoscopic transection of the pancreatic neck with enucleation of intraductal papillary mucinous neoplasm (IPMN) in the uncinate process and pancreatic reconstruction represents a novel surgical approach for managing pancreatic intraductal papillary mucinous neoplasms. This technique may provide a new therapeutic option for patients with benign or low-grade malignant tumors in the pancreatic uncinate process. This study aimed to assess this procedure's short- and long-term clinical outcomes and delineate its technical operative details. METHODS: For a 42-year-old man, branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) was diagnosed. Abdominal contrast-enhanced computed tomography (CT) showed an irregular cystic lesion in the cephalad portion of the pancreatic uncinate process, with no enhancement on post-contrast imaging. Abdominal MRI demonstrated the irregular cystic lesion (38 × 18 mm), showing suspected communication with the pancreatic duct. Endoscopic ultrasound (EUS) showed a multicystic lesion in the pancreatic uncinate process measuring up to 40 mm in maximum diameter, with heterogeneous wall thickness and well-defined margins. The patient subsequently underwent laparoscopic transection of the pancreatic neck with enucleation of IPMN in the uncinate process and pancreatic reconstruction. RESULTS: The patient experienced a biochemical leak postoperatively, with a daily drainage volume of approximately 20 mL. The drainage volume gradually decreased, and the drain was removed on postoperative day 10, followed by hospital discharge. At this writing, follow-up evaluations have shown no complications such as steatorrhea, secondary diabetes, or dyspepsia. A contrast-enhanced CT scan of the entire abdomen showed no abnormalities. Morphologic and immunohistochemical analyses confirmed the diagnosis of IPMN with mild epithelial dysplasia. CONCLUSION: Laparoscopic transection of the pancreatic neck with enucleation of IPMN in the uncinate process and pancreatic reconstruction represents a safe and effective surgical approach for managing pancreatic uncinate process IPMN.

Source: Annals of Surgical Oncology

DOI: 10.1245/s10434-025-18001-5

Authors: Hengli Gong, Yunqiang Cai, Yanyan Lin, Wenbo Meng

Institutions: Lanzhou University, West China Hospital of Sichuan University, First Hospital of Lanzhou University

Language: English

Topic: Pancreatic and Hepatic Oncology Research

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,590