Utility of the use of intraoperative ultrasound in laparoscopic pancreatic surgery.
EAES Academy. Cerrato Delgado S. 07/05/22; 366520; P237
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Abstract
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OBJECTIVE
To discuss the use of intraoperative pancreatic ultrasound in laparoscopic pancreatic surgery for diagnostic confirmation and surgical delineation.
METHOD:
55-year-old patient presenting with multiple non-functioning pancreatic neuroendocrine pancreatic tumors in the setting of MEN type I syndrome. History of total thyroidectomy for primary hyperparathyroidism and microprolactinoma in treatment with carbegoline.
CT: Two nodular lesions in pancreatic tail. Subcentimeter nodule enhancing in pancreatic body. MRI confirms 2 nodules in the pancreatic tail of 23 and 36 mm, as well as another one of 5 mm in the pancreatic body. Echoendoscopy showed up to 9 hypoechoic solid lesions of 25-25 mm in the head, body and tail of the pancreas, with two larger ones in the tail. FNA was performed and the anatomopathological results were suggestive of tumor with neuroendocrine differentiation.
Total vs. subtotal pancreatectomy was proposed based on intraoperative ultrasound findings. A French approach was performed with 5 trocars (3 of 12 mm and 2 of 5 mm), as shown in the image. Intraoperative ultrasound was performed and multiple pancreatic lesions were observed, mainly located in the pancreatic body and tail.
RESULT
The immediate postoperative period passed without complications and she was discharged on the 5th day. The final pathology report described 8 grade 1 neuroendocrine tumors (ki 67 less than 3%) that did not reach the resection margin. At subsequent revisions the patient remains uncomplicated.
CONCLUSIONS
Intraoperative ultrasound is a useful tool that can aid in intraoperative decision making in laparoscopic pancreatic surgery.
Translated with www.DeepL.com/Translator (free version)
To discuss the use of intraoperative pancreatic ultrasound in laparoscopic pancreatic surgery for diagnostic confirmation and surgical delineation.
METHOD:
55-year-old patient presenting with multiple non-functioning pancreatic neuroendocrine pancreatic tumors in the setting of MEN type I syndrome. History of total thyroidectomy for primary hyperparathyroidism and microprolactinoma in treatment with carbegoline.
CT: Two nodular lesions in pancreatic tail. Subcentimeter nodule enhancing in pancreatic body. MRI confirms 2 nodules in the pancreatic tail of 23 and 36 mm, as well as another one of 5 mm in the pancreatic body. Echoendoscopy showed up to 9 hypoechoic solid lesions of 25-25 mm in the head, body and tail of the pancreas, with two larger ones in the tail. FNA was performed and the anatomopathological results were suggestive of tumor with neuroendocrine differentiation.
Total vs. subtotal pancreatectomy was proposed based on intraoperative ultrasound findings. A French approach was performed with 5 trocars (3 of 12 mm and 2 of 5 mm), as shown in the image. Intraoperative ultrasound was performed and multiple pancreatic lesions were observed, mainly located in the pancreatic body and tail.
RESULT
The immediate postoperative period passed without complications and she was discharged on the 5th day. The final pathology report described 8 grade 1 neuroendocrine tumors (ki 67 less than 3%) that did not reach the resection margin. At subsequent revisions the patient remains uncomplicated.
CONCLUSIONS
Intraoperative ultrasound is a useful tool that can aid in intraoperative decision making in laparoscopic pancreatic surgery.
Translated with www.DeepL.com/Translator (free version)
OBJECTIVE
To discuss the use of intraoperative pancreatic ultrasound in laparoscopic pancreatic surgery for diagnostic confirmation and surgical delineation.
METHOD:
55-year-old patient presenting with multiple non-functioning pancreatic neuroendocrine pancreatic tumors in the setting of MEN type I syndrome. History of total thyroidectomy for primary hyperparathyroidism and microprolactinoma in treatment with carbegoline.
CT: Two nodular lesions in pancreatic tail. Subcentimeter nodule enhancing in pancreatic body. MRI confirms 2 nodules in the pancreatic tail of 23 and 36 mm, as well as another one of 5 mm in the pancreatic body. Echoendoscopy showed up to 9 hypoechoic solid lesions of 25-25 mm in the head, body and tail of the pancreas, with two larger ones in the tail. FNA was performed and the anatomopathological results were suggestive of tumor with neuroendocrine differentiation.
Total vs. subtotal pancreatectomy was proposed based on intraoperative ultrasound findings. A French approach was performed with 5 trocars (3 of 12 mm and 2 of 5 mm), as shown in the image. Intraoperative ultrasound was performed and multiple pancreatic lesions were observed, mainly located in the pancreatic body and tail.
RESULT
The immediate postoperative period passed without complications and she was discharged on the 5th day. The final pathology report described 8 grade 1 neuroendocrine tumors (ki 67 less than 3%) that did not reach the resection margin. At subsequent revisions the patient remains uncomplicated.
CONCLUSIONS
Intraoperative ultrasound is a useful tool that can aid in intraoperative decision making in laparoscopic pancreatic surgery.
Translated with www.DeepL.com/Translator (free version)
To discuss the use of intraoperative pancreatic ultrasound in laparoscopic pancreatic surgery for diagnostic confirmation and surgical delineation.
METHOD:
55-year-old patient presenting with multiple non-functioning pancreatic neuroendocrine pancreatic tumors in the setting of MEN type I syndrome. History of total thyroidectomy for primary hyperparathyroidism and microprolactinoma in treatment with carbegoline.
CT: Two nodular lesions in pancreatic tail. Subcentimeter nodule enhancing in pancreatic body. MRI confirms 2 nodules in the pancreatic tail of 23 and 36 mm, as well as another one of 5 mm in the pancreatic body. Echoendoscopy showed up to 9 hypoechoic solid lesions of 25-25 mm in the head, body and tail of the pancreas, with two larger ones in the tail. FNA was performed and the anatomopathological results were suggestive of tumor with neuroendocrine differentiation.
Total vs. subtotal pancreatectomy was proposed based on intraoperative ultrasound findings. A French approach was performed with 5 trocars (3 of 12 mm and 2 of 5 mm), as shown in the image. Intraoperative ultrasound was performed and multiple pancreatic lesions were observed, mainly located in the pancreatic body and tail.
RESULT
The immediate postoperative period passed without complications and she was discharged on the 5th day. The final pathology report described 8 grade 1 neuroendocrine tumors (ki 67 less than 3%) that did not reach the resection margin. At subsequent revisions the patient remains uncomplicated.
CONCLUSIONS
Intraoperative ultrasound is a useful tool that can aid in intraoperative decision making in laparoscopic pancreatic surgery.
Translated with www.DeepL.com/Translator (free version)
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