Pancreatoduodenectomy for circumportal pancreas accompanying the retroportal pancreatic duct: a case report and review of the literature

Springer Science and Business Media LLC - Tập 5 - Trang 332-335 - 2012
Tatsuya Shonaka1, Mitsuhiro Inagaki1, Hiromitsu Akabane1, Naoyuki Yanagida1, Hiroki Shomura1, Takeaki Kudo1, Tatsuya Orimo1, Futoshi Oikawa1, Takeshi Aiyama1, Nobuyuki Yanagawa2, Kensuke Oikawa3, Shiro Nakano1
1Division of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
2Division of Gastroenterology, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan
3Division of Pathology, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan

Tóm tắt

Circumportal pancreas (CP) is an extremely rare pancreatic fusion anomaly which is usually asymptomatic. This report presents the case of a patient with a tumor in the head of a CP and the retroportal accessory pancreatic duct in the pancreatic tissue behind the portal vein. A 53-year-old male was diagnosed with a nonfunctioning neuroendocrine tumor of the pancreas and resection of the tumor was scheduled. The patient was revealed to have CP on preoperative computed tomography and endoscopic retrograde cholangiopancreatography, which showed the pancreatic tissue encircling the portal vein and the retroportal accessory pancreatic duct. The patient safely underwent pylorus-preserving pancreatoduodenectomy reconstructed with pancreaticogastrostomy.

Tài liệu tham khảo

Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Neoptolemos J, et al. Postoperative pancreatic fistula: an international study group (ASGPF) definition. Surgery. 2005;138:8–13. Sandrasegaran K, Petel A, Fogel EL, Zyromski NJ, Pitt HA. Annular pancreas in adults. AJR. 2009;193:455–60. Klein SD, Affronti JP. Pancreas divisum, an evidence-based review: part I, pathophysiology. Gastrointest Endosc. 2004;60:419–25. Klein SD, Affronti JP. Pancreas divisum, an evidence-based review: part II, patient selection and treatment. Gastrointest Endosc. 2004;60:585–9. Hamanaka Y, Evans J, Sagar G, Neoptolemos JP. Complete pancreatic encasement of the proximal hepatic portal vein: a previously undescribed congenital anomaly. Br J Surg. 1997;84(6):785. Marjanovic G, Obermaier R, Benz S, Bley ST, Juettner E, Hopt UT, Adam U. Complete pancreatic encasement of the portal vein—surgical implications of an extremely rare anomaly. Langenbecks Arch Surg. 2007;392:489–91. Sugiura Y, Shima S, Yonekawa H, Yoshizumi Y, Ohtsuka H, Ogata T. The hypertrophic uncinate process of the pancreas wrapping the superior mesenteric vein and artery—a case report. Jpn J Surg. 1987;17:182–5. Leyendecker JR, Baginski SG. Complete encasement of the portal vein (circumportal pancreas): imaging findings and implications of a rare pancreatic anomaly. J Comput Tomogr. 2008;32:61–4. Kin T, Shapiro AM. Circumportal pancreas and islet isolation. Surgery. 2009;146:126–7. Karasaki H, Mizukami Y, Ishizaki A, Goto J, Yoshikawa D, Kino S, et al. Portal annular pancreas, a notable pancreatic malformation: frequency, morphology, and implications for pancreatic surgery. Surgery. 2009;146:515–8. Hashimoto Y, Ross AS, Traverso LW. Circumportal pancreas with retroportal main pancreatic duct. Pancreas. 2009;38:713–5. Kin T, Shapiro J. Partial dorsal agenesis accompanied with circumportal pancreas in a donor for islet transplantation. Islets. 2010;2:146–8. Joseph P, Raju RS, Vyas FL, Eapen A, Sitaram V. Portal annular pancreas. A rare variant and a new classification. J Pancreas. 2010;11:453–5. Matsumoto I, Shinzeki M, Fukumoto T, Ku Y. An extremely rare portal annular pancreas for pancreaticoduodenectomy with a special note on the pancreatic duct management in the dorsal pancreas. Surgery. 2011. doi: 10.1016/j.surg.2011.08.017. Gonoi W, Akahane M, Akai H, Hagiwara K, Kiryu S, Hayashi N, et al. Retroportal main pancreatic duct with circumportal pancreas: radiographic visualization. Clin Imaging. 2011;35:442–6.