Pancreaticogastrostomy for pancreatic body cystic neoplasms: An organ-sparing approach

Highlights • Distal pancreatectomy is the surgical operation of choice for cysts located on the body and tail of pancreas. • Distal pancreatectomy for pancreatic body cysts can result in loss of healthy distal pancreatic tissue. • Central pancreatectomy is an alternative surgical operation of choice of cysts located on pancreatic body. • Central pancreatectomy preserves distal healthy pancreas tissue. • Distal pancreas tissue can be anastomosed to the stomach when central pancreatectomy is performed.
Introduction Surgical management of pancreatic cysts differ according to the specific location of the cyst on the pancreas. Cysts located on the pancreatic head require a radical procedure such as pancreaticoduodenectomy (Whipple procedure). Cysts of the pancreatic body or tail, however, require distal pancreatectomy as the standard surgical approach. An alternative surgical approach for cysts located in the mid-pancreas is central pancreatectomy with distal pancreaticogastrostomy. Presentation of case In this report, we present a case of a 22-year-old woman with a cyst located on the mid-pancreas consistent with a solid pseudopapillary neoplasia. Central pancreatectomy with distal pancreaticogastrostomy was the surgical technique of choice performed in this case. Discussion Central pancreatectomy has emerged as an alternative surgical approach to mid-pancreatic cysts which includes only the removal of a segment of the pancreas, thereby sparing the distal parenchyma. Compared with the traditional approach, this technique of partial resection of the pancreatic tissue is desirable due to its organ-sparing function. Conclusion Central pancreatectomy with distal pancreaticogastrostomy can be an alternative to distal pancreatectomy for cysts located in the mid-pancreatic region. This rare procedure prevents any unnecessary healthy pancreatic tissue loss, reduces the risk of developing complications, and is an alternative treatment of choice to distal pancreatectomy.