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Robotic assisted laparoscopic completion pancreatectomy for recurrent intraductal papillary mucinous neoplasm after previous open pancreatoduodenectomy: A case report and literature review
Ann Hepatobiliary Pancreat Surg 2019 May;23(2):206-9
Published online May 31, 2019;  https://doi.org/10.14701/ahbps.2019.23.2.206
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Pyae Pa Pa Kyaw1, Brian K. P. Goh1,2

1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 2Duke-NUS Medical School, Singapore
Received December 14, 2018; Revised January 22, 2019; Accepted January 30, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Completion pancreatectomy (CP), is an effective, and potentially curative option for selected patients with local recurrence of pancreatic neoplasms in the remnant pancreas after initial pancreatoduodenectomy (PD). Traditionally CP has been performed via the open approach. Reports of minimally-invasive CP particularly after previous open PD are rare. We present a case of a 72-year old male who previously underwent open PD 5 years ago for intraductal papillary mucinous neoplasm (IPMN) with high grade dysplasia in the uncinate process. He had multifocal IPMN and low-risk lesions in the body and tail were managed conservatively. On routine surveillance, the cyst in the body was noted to be increasing in size with the development of a non-enhancing solid component confirmed on magnetic resonance imaging and subsequent endoscopic ultrasonography. The patient underwent successful robotic assisted laparoscopic completion pancreatectomy. Final histology confirmed a recurrent IPMN with low-to-intermediate grade dysplasia. The postoperative recovery was uneventful and he was discharged on postoperative day 9.
Keywords : Completion pancreatectomy; Laparoscopic pancreatectomy; Robotic pancreatectomy; Minimally invasive pancreatectomy; Total remnant pancreatectomy