Abstract
A 62-year-old man admitted to another hospital suffered severe diarrhea, high blood sugar and hyperketonemia in December 2010. He had been treated for diabetes for 10 years and deformation of the pancreas was pointed out in 2007. After various examinations, pancreatic VIPoma with a metastatic lesion in the liver was diagnosed and he was transferred to our hospital in January 2011. Although it was possible to control electrolytes and dehydration, watery diarrhea could not be controlled. Our examinations further revealed concurrent cholecystolithiasis and choledocolithiasis, thus we decided to treat surgically. In early February, distal pancreatectomy with splenectomy, partial hepatectomy, cholecystectomy and choledocolithotomy were performed. Diarrhea reduced after the tumor resection and stopped on the first postoperative day. Serum VIP levels declined significantly after three hours from resection, and hyperglycemia, face flushing and hypercalcemia improved by the third post operation day.
