Central Pancreatectomy for Neuro Endocrine Tumor of Pancreas -The Holy Criteria Revisited - A case report

Dr. Subbiah Shanmugam; Dr. Gopu Govindasamy; Dr. Syed Afroze Hussain; Dr. Gurumoorthy Narayanasamy

Volume : VII, Issue : VII, July - 2018

Central Pancreatectomy for Neuro Endocrine Tumor of Pancreas -The Holy Criteria Revisited - A case report

Dr. Subbiah Shanmugam, Dr. Gopu Govindasamy, Dr. Syed Afroze Hussain, Dr. Gurumoorthy Narayanasamy

Abstract :

Pancreatic neuroendocrine tumorsare rare low grade neoplasms with indolent course. Surgery is the only potentially curative treatment. Their location in neck of pancreas can pose surgical dilemma since enucleation may not always be feasible due to size of the lesion and proximity to main pancreatic duct, whereas pancreatico duodenectomy and distal pancreatectomy would result in exocrine and endocrine insufficiency due to functional parenchymal loss. In such patients central pancreatectomy remains a safe alternative. We report here a case of neuroendocrine tumor of neck of pancreas managed by central pancreatectomy. Though criteria restrict this rare procedure to lesions less than 5cm, we have safely performed the same for a larger lesion without any morbidity. Hence central pancreatectomy in selected patients provides a perfectly balanced option between enucleation and more radical pancreatico duodenectomy or distal pancreatectomy. We have reviewed literature and discussed the feasibilty and advantages of central pancreatectomy and techniques involved.