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Background <p>With the application of new technologies such as three-dimensional and fluorescent staining, laparoscopic surgery is more comprehensive, accurate, and safe.<sup><CitationRef AdditionalCitationIDS="CR2" CitationID="CR1">1</CitationRef>–<CitationRef CitationID="CR3">3</CitationRef></sup> For specific borderline or benign pancreatic head tumors that are small, well-differentiated, and have an intact capsule, laparoscopic local enucleation of the pancreatic head tumor is the preferred surgical approach;<sup><CitationRef CitationID="CR4">4</CitationRef>,<CitationRef CitationID="CR5">5</CitationRef></sup> however, when the tumor involves the pancreatic duct, it is often necessary to resect the pancreatic duct and reconstruct it. This paper introduces a local resection of the pancreatic head tumor with end-to-end anastomosis of the pancreatic duct under fluorescence laparoscopy. According to literature review, there are no reports regarding end-to-end anastomosis of the pancreatic head duct under laparoscopy.</p> Patient and&#xa0;methods <p>Using magnetic resonance imaging (MRI) examination, a 35-year-old female was found to have a solid pseudopapillary neoplasm in the pancreatic head sized 5.4 × 3.8 × 4.2&#xa0;cm. We performed fluorescence laparoscopic local resection of the pancreatic head tumor. During the operation, the tumor involved the main pancreatic duct, and Takada's end-to-end anastomosis of the pancreatic duct was performed.</p> Results <p>The duration of the operation was 180&#xa0;min and blood loss was 100&#xa0;mL. The patient recovered smoothly and was discharged on the eighth day after operation. Postoperative pathology suggested a solid pseudopapillary neoplasm. There was no dilation of the pancreatic duct 3&#xa0;months after surgery.</p> Conclusion <p>Laparoscopic local tumor enucleation has been widely accepted in the treatment of small, well-encapsulated, well-differentiated benign tumors of the pancreatic head. When the pancreatic head tumor involves the main pancreatic duct, Takada’s end-to-end anastomosis of the pancreatic duct provides a new surgical strategy.</p>

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Fluorescence Laparoscopic Local Resection of Pancreatic Head Tumor with End-to-End Pancreatic Anastomosis: A New Surgical Strategy for Pancreatic Head Tumor Resection

  • 期刊论文

  • 发表日期：

    2025年4月2日

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  • Jianlin Lai,
  • Haoxiang Zhang,
  • Long Huang,
  • Yifeng Tian,
  • Shi Chen

摘要

Background

With the application of new technologies such as three-dimensional and fluorescent staining, laparoscopic surgery is more comprehensive, accurate, and safe.1–3 For specific borderline or benign pancreatic head tumors that are small, well-differentiated, and have an intact capsule, laparoscopic local enucleation of the pancreatic head tumor is the preferred surgical approach;4,5 however, when the tumor involves the pancreatic duct, it is often necessary to resect the pancreatic duct and reconstruct it. This paper introduces a local resection of the pancreatic head tumor with end-to-end anastomosis of the pancreatic duct under fluorescence laparoscopy. According to literature review, there are no reports regarding end-to-end anastomosis of the pancreatic head duct under laparoscopy.

Patient and methods

Using magnetic resonance imaging (MRI) examination, a 35-year-old female was found to have a solid pseudopapillary neoplasm in the pancreatic head sized 5.4 × 3.8 × 4.2 cm. We performed fluorescence laparoscopic local resection of the pancreatic head tumor. During the operation, the tumor involved the main pancreatic duct, and Takada's end-to-end anastomosis of the pancreatic duct was performed.

Results

The duration of the operation was 180 min and blood loss was 100 mL. The patient recovered smoothly and was discharged on the eighth day after operation. Postoperative pathology suggested a solid pseudopapillary neoplasm. There was no dilation of the pancreatic duct 3 months after surgery.

Conclusion

Laparoscopic local tumor enucleation has been widely accepted in the treatment of small, well-encapsulated, well-differentiated benign tumors of the pancreatic head. When the pancreatic head tumor involves the main pancreatic duct, Takada’s end-to-end anastomosis of the pancreatic duct provides a new surgical strategy.