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<p>Portal vein aneurysm (PVA) is a rare vascular condition, particularly when located in the retropancreatic space, where it may mimic pancreatic pathology or cause compressive symptoms. We report the case of a 69-year-old woman presenting with chronic postprandial pain and severe weight loss due to a 37&#xa0;mm extrahepatic PVA compressing the neck of the pancreas and the main pancreatic duct. After failure of conservative management consisting of clinical observation and analgesic therapy, the patient underwent a totally laparoscopic central pancreatectomy, complete aneurysm excision, and portal vein reconstruction using a bovine pericardial patch. All steps, including vascular repair and pancreatojejunostomy with intraductal stenting, were performed intracorporeally. Postoperative recovery was uneventful, and long-term follow-up with contrast-enhanced 3D imaging confirmed vascular patency and complete symptom resolution. To our knowledge, this is the first video-documented case of a laparoscopic central pancreatectomy for retropancreatic PVA with biological venous reconstruction, highlighting a feasible and safe minimally invasive approach to complex vascular-pancreatic pathology.</p>

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Minimally Invasive Management of a Bulky Retropancreatic Portal Vein Aneurysm: Laparoscopic Central Pancreatectomy and Intracorporeal Venous Patch Reconstruction – A Video Report

  • 期刊论文

  • 发表日期：

    2026年1月16日

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  • Alessia Fassari,
  • Vito De Blasi,
  • Edoardo Rosso

摘要

Portal vein aneurysm (PVA) is a rare vascular condition, particularly when located in the retropancreatic space, where it may mimic pancreatic pathology or cause compressive symptoms. We report the case of a 69-year-old woman presenting with chronic postprandial pain and severe weight loss due to a 37 mm extrahepatic PVA compressing the neck of the pancreas and the main pancreatic duct. After failure of conservative management consisting of clinical observation and analgesic therapy, the patient underwent a totally laparoscopic central pancreatectomy, complete aneurysm excision, and portal vein reconstruction using a bovine pericardial patch. All steps, including vascular repair and pancreatojejunostomy with intraductal stenting, were performed intracorporeally. Postoperative recovery was uneventful, and long-term follow-up with contrast-enhanced 3D imaging confirmed vascular patency and complete symptom resolution. To our knowledge, this is the first video-documented case of a laparoscopic central pancreatectomy for retropancreatic PVA with biological venous reconstruction, highlighting a feasible and safe minimally invasive approach to complex vascular-pancreatic pathology.