腹腔鏡下膵体尾部切除術を施行した膵serous cystadenomaの1例

A Case of Laparoscopic Distal Pancreatectomy for Serous Cystadenoma of the Pancreas

　症例は68歳の女性．検診の腹部超音波検査で胆石を指摘され受診し，腹部CTで膵尾部に腫瘍が発見された．ERCP，血管造影検査により胆石症および非機能性膵内分泌腫瘍と診断され，腹腔鏡下手術を施行した．腹腔鏡下で観察すると，腫瘍は膵尾部に存在していた．脾動静脈，膵体部をそれぞれendoscopic linear staplerを用いて切離した．胆嚢は通常の腹腔鏡下胆嚢摘出術を施行した．手術時間は312分で，出血量は50ml以下であった．術後経過は良好で，術後13日目に退院となった．腫瘍は2.8×2.4cmで，病理組織学的にはserous cystadenomaと診断された．膵良性腫瘍に対する腹腔鏡下膵尾部切除術は，比較的安全に施行可能で，低侵襲な手術であり，将来的に第一選択の治療法になりうると考えられた．

A 68-year-old woman was diagnosed as having a gall bladder stone by abdominal ultrasonography. Abdominal compated tomography revealed a tumor of the pancreatic tail. Diagnoses of non-functional endocrine tumor of the pancreas and gall bladder stone were made by endoscopic retrograde cholangiopancreatography and angigraphy, and laparoscopic surgery was performed. The tumor was located at the pancreatic tail. Splenic artery and vein and pancreatic body were cut by the endoscopic linear stapler. We also performed laparoscopic cholecystectomy. The operation time was 312 minutes and the blood loss was less than 50ml.