Laparoscopic duodenum and spleen-preserving total pancreatectomy: A novel surgical technique for pancreatic intraductal papillary mucinous neoplasms

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Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is no longer a rarely diagnosed disease, because of the development of medical imaging. With a high incidence of canceration, especially in the main duct type, surgery is strongly recommended. Pancreatoduodenectomy, distal pancreatectomy and central pancreatectomy are applied in those cases. For this potentially malignant disease, function-preserving surgery seems more appropriate. An old female was enrolled in our research, who was diagnosed with IPMN. Diameter of the main pancreatic duct (MPD) was > 5 mm and lesions distributed to the whole pancreas. laparoscopic duodenum and spleen-preserving total pancreatoduodenectomy was carried out, which has not reported previously. We successfully performed laparoscopic duodenum and spleen-preserving total pancreatectomy, without major complications such as severe pancreatic fistula, postoperative bleeding, and delayed ischemia of duodenum and spleen. We consider laparoscopic duodenum and spleen-preserving total pancreatectomy is technically feasible, but a large sample of randomized controlled trials is needed to evaluate its safety, effectiveness and long-term outcome.