Total laparoscopic duodenum-preserving pancreatic head resection for solid pseudopaillary neoplasm of pancreas: A case report

RATIONALE: There is controversy regarding the optimal surgical approach for pancreatic lesions in the head of the pancreas. Duodenum-preserving pancreatic head resection compared with pancreaticoduodenectomy is technically more challenging, but preserves more functional pancreatic tissue. PATIENT CONCERNS: A 25-year-old woman was admitted to our department on May 10, 2017. Computed tomographic's saw a 2.0 × 2.1-cm lesion located in the head of pancreas and its diagnosis was nonfunctional neuroendocrine tumors? The magnetic resonance cholangiopancreatography scan demonstrated a solitary 1.6 × 1.7-cm lesion located in the head of pancreas, and its diagnosis was tumor. The patient's condition was good and symptomless, without any disease history. Physical examination and routine blood investigations were normal. All pancreatic malignant tumor biological markers were negative. DIAGNOSES: Solid pseudopapillary neoplasm of pancreas. INTERVENTIONS: Total laparoscopic head pancreatectomy with Roux-Y pancreaticojejunostomy was performed. OUTCOMES: The recovery was smooth after surgery. At the end of 20 months follow-up, she was well and showed no signs of recurrence. LESSONS: The anatomy of the operation is clearer and easier than open surgery because of the magnification effect of laparoscopy. Total laparoscopic head pancreatectomy is safe, effective, and feasible for solid pseudopapillary neoplasm of pancreas, and it should be equally applicable to some other pancreatic cystic neoplasms and neuro-endocrine tumors.