Laparoscopic distal pancreatectomy for Frantz?s tumor in a child

Abstract

Solid pseudopapillary tumor of the pancreas is a rare pathologic entity. Although the role of laparoscopy in surgery of the pancreas is still controversial, laparoscopic distal pancreatectomy has been reported with good results in adults. We report a laparoscopic spleen-preserving distal pancreatectomy in a 9-year-old boy who presented with a low-grade malignant tumor. Needle biopsy was impossible. A laparoscopic spleen-preserving distal pancreatectomy was performed. We used four trocars, and the operative time was 240 min. Conversion to open surgery was not necessary. The boy's postoperative recovery was uneventful, and he was discharged on the 6th day. CT-scan control at 6 months was normal. This case shows that even in advanced surgical cases, such as spleen-preserving distal pancreatectomy, laparoscopic procedures can be done safely, within a reasonable operative time, in children.

Solid pseudopapillary tumor of the pancreas: a multicenter study of 23 pediatric cases

“…Recently, simple tumor enucle atio n [11,18] o r laparoscopi c dist al pancreatect omy [11,20] has be en attempt ed when the mass is diagnosed as SPT before resection. In these cases, radiologic study, NAB, and the size of mass must reveal an SPT small enough to war rant tissue spari ng surgery [10,[17][18][19][20][21]. As happened in this study, the risk of postoperative pancreatic leakage or edematous pancreatitis increases when the tissue-sparing surgery is performed.…”

“…Po sitron emi ssion tom ography scan usual ly show s increased fluor odeoxygl ucose uptake in SPT [16]. There has been much controversy on the optimal surgical procedu re for the treat ment of SPT [10,[17][18][19][20][21][22]. Pa ncreaticoduodenectomy is commonly used to resect SPTs located in the pancreatic head, whereas distal pancreatectomy is used for those in the tail.…”

Laparoscopic distal pancreatectomy in children with solid pseudopapillary tumour (Frantz tumour) – a report of two cases and review of the literature

“…In recent years, DP has been increasingly performed by a minimally invasive laparoscopic approach [4,[7][8][9][10]. However, the number of publications and published series is small, especially in children [11,12]. This can be explained by the technical difficulty due to the complex location of the organ in the retroperitoneum, its relation to surrounding organs and major vascular structures, and to the precarious pancreatic physiology and the high risk of postoperative complications, especially pancreatic leak [10,13].…”

Laparoscopic pancreatectomy for persistent hyperinsulinemic hypoglycemia of infancy

“…Most of these reports are among adult population with mostly distal pancreatectomies. Few case reports have shown the feasibility of the technique in the pediatric population [8][9][10], and only 2 reports have 3 patients with PHHI [11,12]. We report our experience with laparoscopic pancreatectomy for PHHI for the last 4 years.…”