{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:53:51Z","timestamp":1740174831113,"version":"3.37.3"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"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>There is no standard surgical method for treating pancreatic head tumors with fat replacement of the pancreatic body and tail. Total pancreatectomy procedures are usually performed to excise pancreatic head tumors and lead to endocrine function loss and subsequent development of diabetes. We present a rare case where the adipose tissue was preserved during pancreaticoduodenectomy in a patient with a solid pseudopapillary neoplasm and fat-replaced pancreatic body and tail.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>Contrast-enhanced computed tomography scans of a 43-year-old man revealed a tumor measuring approximately 3\u2009cm in size with calcification in the pancreatic head. Magnetic resonance cholangiopancreatography showed that the pancreatic ducts in the body and tail were completely disrupted. Furthermore, endoscopic ultrasonography showed no pancreatic parenchyma in the body and tail of the pancreas, with disruption in the main pancreatic duct. Endoscopic ultrasonography-guided fine-needle aspiration led to the final pathological diagnosis of a solid pseudopapillary neoplasm, and laparoscopic total pancreatectomy was performed. However, intraoperative findings indicated that the tumor was located in the pancreatic head. Pancreatic parenchyma was not observed in the pancreatic body or tail, as it had been completely replaced with adipose tissue. Nevertheless, the shape of the pancreas was identifiable. Therefore, pancreaticoduodenectomy was performed to transect parenchyma at the pancreatic neck, while preserving the adipose tissue present in the pancreatic body. The main pancreatic duct could not be identified at the cut surface. Therefore, we performed modified Blumgart-style pancreaticojejunostomy to cover the cut end instead of reconstructing the pancreatic duct. The patient was discharged on postoperative day 12 without complications and is being followed-up as an outpatient. His fasting blood sugar and hemoglobin A1c levels according to the National Glycohemoglobin Standardization Program reports were within normal limits, indicating that the endocrine function (insulin secretion ability) was preserved during the 1.5\u2009years following surgery.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In patients with pancreatic head tumors, pancreaticoduodenectomy that preserves fat-replaced pancreatic body and tail tissues can preserve postoperative endocrine function.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00894-x","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T11:04:28Z","timestamp":1592219068000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pancreaticoduodenectomy for preservation of fat-replaced pancreatic body and tail tissue in a patient with solid pseudopapillary neoplasm: a case report"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5674-2001","authenticated-orcid":false,"given":"Toru","family":"Sakurai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Nagakawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Takishita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Osakabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoe","family":"Nishino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Akashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Okazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Katsumata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Tsuchida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,6,15]]},"reference":[{"key":"894_CR1","first-page":"771","volume":"14","author":"D Fukata","year":"1991","unstructured":"Fukata D, Tanaka S, Ito T, Oshita H, Tachibana S, Goshima H, et al. A case of pancreas head carcinoma complicated with aplasia of the pancreatic body and tail. Gastroenterol Surg. 1991;14:771\u20136.","journal-title":"Gastroenterol Surg"},{"key":"894_CR2","first-page":"583","volume":"7","author":"T Furuichi","year":"1996","unstructured":"Furuichi T, Uchida T, Nagata Y, Hashimoto Y. A case of pancreas head carcinoma with aplasia of the pancreatic body and tail. J Biliary Tract Pancreas. 1996;7:583\u20138.","journal-title":"J Biliary Tract Pancreas"},{"key":"894_CR3","first-page":"1269","volume":"59","author":"M Kishinaka","year":"1997","unstructured":"Kishinaka M, Nishiura S, Kawasaki H, Yoshitomi S, Kimura T. Malignant endocrine tumor of pancreas head with partial pancreas hypoplasia. Surgery. 1997;59:1269\u201372.","journal-title":"Surgery."},{"key":"894_CR4","first-page":"801","volume":"53","author":"N Kuroki","year":"1999","unstructured":"Kuroki N, Shimayama T, Ikeda T, Sakihama K, Setoguchi T. A surgical case of pancreatic cancer with agenesis of body and tail of the pancreas (in Japanese). Operation. 1999;53:801\u20134.","journal-title":"Operation"},{"key":"894_CR5","first-page":"437","volume":"55","author":"Y Nio","year":"2001","unstructured":"Nio Y, Itakura M, Endo S, Watanabe H. Operation. Pylorus-preserving pancreaticoduodenectomy for pancreatic head cancer with agenesis of body and tail of the pancreas (in Japanese). Operation. 2001;55:437\u201341.","journal-title":"Operation"},{"key":"894_CR6","doi-asserted-by":"publisher","first-page":"645","DOI":"10.5833\/jjgs.35.645","volume":"35","author":"N Kanazumi","year":"2002","unstructured":"Kanazumi N, Takeda S, Miyoshi K, Kaneko T, Nakao A. A case of agenesis of the pancreatic body and tail with the lower bile duct carcinoma. 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