A Case of Subtotal Distal Pancreatectomy for Intraductal Papillary Mucinous Neoplasm with Pancreas Divisum

Abstract

We report the case of a patient with intraductal papillary mucinous neoplasm (IPMN) with pancreas divisum who underwent subtotal distal pancreatectomy. A 74-year-old woman with pancreatitis was found to have pancreas divisum and diffuse dilatation of the Santorini duct on CT and ERCP. Mixed type IPMN localized at the dorsal pancreas was diagnosed and subtotal distal pancreatectomy with transection between the ventral and dorsal pancreas was performed to avoid total pancreatectomy. Postoperative pancreatic fistula was treated conservatively. A histological study revealed low grade IPMN without malignant findings. This case shows the importance of considering the anatomical variant in determining the extent of resection in pancreatectomy for a borderline malignant tumor.