学術雑誌論文 Laparoscopic Distal Pancreatectomy Using a Double-Balloon Catheter for Treatment of a Large Pancreatic Mucinous Cystic Neoplasm

Hodaka, Moriyama  ,  Koji, Asai  ,  Manabu, Watanabe  ,  Hiroshi, Matsukiyo  ,  Tomoaki, Saito  ,  Tomotaka, Ishii  ,  Takaharu, Kiribayashi  ,  Toshiyuki, Enomoto  ,  Yoshihisa, Saida  ,  Yasunori, Enomoto  ,  Shinya, Kusachi

1 ( 4 )  , pp.85 - 91 , 2015-12 , The Medical Society of Toho University
ISSN:21891990
内容記述
Case Report
We report a case of a large (diameter>20 cm) mucinous cystic neoplasm (MCN) treated with laparoscopic distal pancreatectomy (LDP) using a double-balloon catheter. A 70-year-old woman presented to our hospital with epigastric pain and abdominal distention. Imaging studies revealed a large cystic mass in the left upper abdominal quadrant. No mural nodule was observed in the cyst. On the basis of these findings, we diagnosed a large pancreatic MCN. There was no evidence of malignancy, and LDP was considered to be the most appropriate treatment for this patient. Under pneumoperitoneum of 10 mmHg CO2, 5 trocars were inserted. Laparoscopic findings revealed that the cystic lesion occupied the left upper abdominal quadrant and that the surgical fields were limited. After dissecting the anterior surface of the cystic wall, a double-balloon catheter was used for intracorporeal aspiration of cystic fluid, as the initial step of surgery. In total, 3000 ml of serous brown fluid was aspirated, and no fluid leaked into the abdominal cavity during aspiration. A satisfactory laparoscopic view was obtained after aspiration, and LDP was performed safely. Pathologic findings revealed pancreatic mucinous cystic adenoma with ovarian-type stroma. The patient’s postoperative course was uneventful, and she was discharged 10 days after surgery. Use of a double-balloon catheter for large MCNs is extremely important because it is safe laparoscopically and prevents leakage of cystic fluid into the abdominal cavity.
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