Volume 17, Issue 4 e13396
CASE REPORT

A case of laparoscopic spleen-preserving distal pancreatectomy for small solid pseudopapillary neoplasm in an adult male with anomalous splenic vein confluence

Sunao Uemura

Corresponding Author

Sunao Uemura

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

Correspondence

Sunao Uemura, Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi 780-8562, Japan.

Email: [email protected]

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Rikiya Daike

Rikiya Daike

Department of Gastroenterology, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Kenji Yorita

Kenji Yorita

Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Hiromichi Yamai

Hiromichi Yamai

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Mitsuteru Yoshida

Mitsuteru Yoshida

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Norihiro Hokimoto

Norihiro Hokimoto

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Hisashi Matsuoka

Hisashi Matsuoka

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Jun Iwabu

Jun Iwabu

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Fuyumi Izaki

Fuyumi Izaki

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Michiyo Okazaki

Michiyo Okazaki

Department of Gastroenterology, Japanese Red Cross Kochi Hospital, Kochi, Japan

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Nobuyuki Tanida

Nobuyuki Tanida

Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan

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First published: 10 October 2024

Abstract

Although anomalies of the celiac and/or superior mesenteric arteries are occasionally encountered during abdominal surgery, anomalous venous confluence is seldom reported during pancreatic surgery. Herein, we present a rare case of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for the treatment of a solid pseudopapillary neoplasm in an asymptomatic 37-year-old male with an anomalous splenic vein (SpV) confluence. Computed tomography angiography (CTA) revealed an anomaly of the SpV, which coursed transversely through the superior border of the pancreas, over the celiac artery and into the portal vein, along the superior line of the common hepatic artery. We successfully performed an LSPDP without peripancreatic vessel injury by exposing the SpV and splenic artery through an approach from the superior position of the pancreas. Preoperative imaging, especially CTA, is crucial to ensuring a safe, successful laparoscopic pancreatectomy.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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