PDF(Pubmed)
Abstract：
BACKGROUND: Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a case of a giant mature cystic teratoma of the pancreas that was successfully resected via complete laparoscopic distal pancreatectomy (LDP).
METHODS: A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor. Three years of follow-up revealed that the tumor had increased in size to 18 cm, with hyperintense solid components on diffusion-weighted magnetic resonance imaging. Considering the possibility of malignancy, we decided to perform an LDP. The capsule appeared solid enough to withstand the retraction of the endoscopic forceps. Tumor size made it difficult to dissect the dorsal side of the tumor from the caudal to the cranial side. Early transection of the pancreas and additional ports facilitated dissection of the dorsal side of the tumor. We completed the LDP without intraoperative cyst rupture. On pathological examination, the tumor was diagnosed as a mature cystic teratoma originating from the pancreatic tail. The patient was discharged on postoperative day 13 with no complications.
CONCLUSIONS: LDP may be an option for surgical procedures in patients with large cystic lesions of the pancreatic body or tail. Intraoperative observation of the tumor and surgical refinement are necessary to complete the laparoscopic procedure without tumor rupture.
METHODS: A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor. Three years of follow-up revealed that the tumor had increased in size to 18 cm, with hyperintense solid components on diffusion-weighted magnetic resonance imaging. Considering the possibility of malignancy, we decided to perform an LDP. The capsule appeared solid enough to withstand the retraction of the endoscopic forceps. Tumor size made it difficult to dissect the dorsal side of the tumor from the caudal to the cranial side. Early transection of the pancreas and additional ports facilitated dissection of the dorsal side of the tumor. We completed the LDP without intraoperative cyst rupture. On pathological examination, the tumor was diagnosed as a mature cystic teratoma originating from the pancreatic tail. The patient was discharged on postoperative day 13 with no complications.
CONCLUSIONS: LDP may be an option for surgical procedures in patients with large cystic lesions of the pancreatic body or tail. Intraoperative observation of the tumor and surgical refinement are necessary to complete the laparoscopic procedure without tumor rupture.
摘要：
背景：胰腺的成熟囊性畸胎瘤或皮样囊肿由于其解剖位置和不断增大的尺寸而使手术方法复杂化。在这里，我们报告了一例巨大的成熟胰腺囊性畸胎瘤，通过完全腹腔镜远端胰腺切除术（LDP）成功切除。
方法：一名39岁的女性患者被转诊到我们医院进行胰腺肿瘤的评估。三年的随访显示，肿瘤的大小增加到18厘米，在弥散加权磁共振成像中具有高强度固体成分。考虑到恶性肿瘤的可能性，我们决定执行自民党。胶囊看起来足够坚固以承受内窥镜钳的缩回。肿瘤的大小使得难以从尾部到颅侧解剖肿瘤的背侧。胰腺的早期横切和其他端口促进了肿瘤背侧的解剖。我们完成了LDP，术中没有囊肿破裂。在病理检查中，该肿瘤被诊断为起源于胰尾的成熟囊性畸胎瘤。患者于术后第13天出院，无并发症。
结论：LDP可能是胰腺体或尾部大囊性病变患者的手术选择。术中观察肿瘤和手术细化是完成腹腔镜手术而不发生肿瘤破裂的必要条件。
方法：一名39岁的女性患者被转诊到我们医院进行胰腺肿瘤的评估。三年的随访显示，肿瘤的大小增加到18厘米，在弥散加权磁共振成像中具有高强度固体成分。考虑到恶性肿瘤的可能性，我们决定执行自民党。胶囊看起来足够坚固以承受内窥镜钳的缩回。肿瘤的大小使得难以从尾部到颅侧解剖肿瘤的背侧。胰腺的早期横切和其他端口促进了肿瘤背侧的解剖。我们完成了LDP，术中没有囊肿破裂。在病理检查中，该肿瘤被诊断为起源于胰尾的成熟囊性畸胎瘤。患者于术后第13天出院，无并发症。
结论：LDP可能是胰腺体或尾部大囊性病变患者的手术选择。术中观察肿瘤和手术细化是完成腹腔镜手术而不发生肿瘤破裂的必要条件。
