Endoscopic linear stapler-assisted resection of a giant solid pseudopapillary pancreatic tumor with concurrent regional portal hypertension: a case report

J Int Med Res. 2018 Jul;46(7):3000-3008. doi: 10.1177/0300060518775246. Epub 2018 Jun 4.

Abstract

Solid pseudopapillary tumor of the pancreas (SPTP) is a rare neoplasm with a low incidence and low rate of malignancy. We herein report a rare case of SPTP concurrent with regional portal hypertension (RPH) that was successfully treated by distal pancreatectomy and splenectomy. A 22-year-old woman presented with a left upper abdominal apophysis and normal liver function. She was diagnosed with an SPTP and RPH by abdominal ultrasound and computed tomography, and she subsequently underwent distal pancreatectomy and splenectomy. Noticeably, varicose vein plexus with wide range appeared on the upper edge of the pancreatic body and posterior gastric wall of the patient. Therefore, we created a path to avoid touching the varicose veins and took advantage of the endoscopic linear stapler to staple the veins. We herein report our surgical experience on SPTP assisted with the endoscopic linear stapler, which will be very realistic for the management of this rare clinical entity.

Keywords: Solid pseudopapillary tumor of the pancreas; apophysis; distal pancreatectomy; endoscopic linear stapler; regional portal hypertension; splenectomy.

Publication types

  • Case Reports

MeSH terms

  • Endoscopy, Digestive System
  • Female
  • Humans
  • Hypertension, Portal / complications*
  • Pancreas / blood supply*
  • Pancreas / surgery*
  • Pancreatectomy / instrumentation
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Splenectomy / instrumentation
  • Splenectomy / methods
  • Surgical Stapling
  • Varicose Veins / surgery*
  • Young Adult