{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:43:15Z","timestamp":1781073795473,"version":"3.54.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Portal annular pancreas (PAP) is a rare pancreatic anomaly in which the uncinate process wraps annularly around the portal vein and fuses to the body of the pancreas. PAP is highly relevant to the development of postoperative pancreatic fistula (POPF) in pancreatic surgery. Here, we describe our experience and surgical technique of laparoscopic spleen-preserving distal pancreatectomy using Warshaw\u2019s procedure for patients with the PAP.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 49-year-old woman with PAP was referred to our hospital for a suspicious mucinous cystic neoplasms 1.5\u2009cm in diameter in the pancreatic tail. Laparoscopic spleen-preserving distal pancreatectomy using Warshaw\u2019s procedure was performed. Mobilization of the pancreatic tail was first performed, and then, the splenic artery was cut. After dividing the pancreatic tail from the splenic hilum, the ventral pancreatic parenchyma was divided using a stapler. After cutting the splenic vein, complete mobilization of the pancreatic body and tail enabled easy division of the PAP. Finally, the PAP was also divided using the stapler. Although grade B POPF occurred, she was discharged on the 9th postoperative day.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Surgeons should understand the anatomical characteristics of PAP and be aware of the possibility of POPF.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00852-7","type":"journal-article","created":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T21:02:27Z","timestamp":1588366947000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["How to divide the pancreatic parenchyma in patients with a portal annular pancreas: laparoscopic spleen-preserving distal pancreatectomy for serous cystic neoplasms"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-0500","authenticated-orcid":false,"given":"Naohisa","family":"Kuriyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohide","family":"Hatanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Gyoten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoi","family":"Hayasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Iizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Tanemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kishiwada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Sakurai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shugo","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,1]]},"reference":[{"key":"852_CR1","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1097\/MPA.0000000000000186","volume":"43","author":"JM Harnoss","year":"2014","unstructured":"Harnoss JM, Harnoss JC, Diener MK, Contin P, Ulrich AB, B\u00fcchler MW, et al. Portal annular pancreas: a systematic review of a clinical challenge. Pancreas. 2014;43:981\u20136.","journal-title":"Pancreas."},{"key":"852_CR2","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/BF02470596","volume":"17","author":"Y Sugiura","year":"1987","unstructured":"Sugiura Y, Shima S, Yonekawa H, Yoshizumi Y, Ohtsuka H, Ogata T. The hypertrophic uncinate process of the pancreas wrapping the superior mesenteric vein and artery--a case report. Jpn J Surg. 1987;17:182\u20135.","journal-title":"Jpn J Surg"},{"key":"852_CR3","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.surg.2009.03.018","volume":"146","author":"H Karasaki","year":"2009","unstructured":"Karasaki H, Mizukami Y, Ishizaki A, Goto J, Yoshikawa D, Kino S, et al. Portal annular pancreas, a notable pancreatic malformation: frequency, morphology, and implications for pancreatic surgery. 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