膵粘液性嚢胞腺腫に対して腹腔鏡補助下脾温存膵体尾部切除術を施行した1例

A case of laparoscopically assisted distal pancreatectomy with preservation of the spleen for mucinous cystadenoma of the pancreas

　患者は44歳の女性．腹痛にて当院受診，精査にて膵体尾部の粘液性嚢胞腺腫と診断され，腫瘍の増大のため入院となった．手術は腹腔鏡補助下脾温存膵体尾部切除を施行した．すなわち腹腔鏡下にて膵脾を十分に脱転，その後小切開を加え体外にて膵体尾部切除ならびに脾動・静脈の？離，脾温存を施行した．手術時間は3時間10分，出血量は110mlであった．術後経過は良好で術後10日目に退院した．病理組織学的には卵巣様間質が認められ，粘液性嚢胞腺腫と診断された．膵体尾部の良性腫瘍あるいは良・悪性境界病変に対する腹腔鏡補助下脾温存膵体尾部切除は低侵襲であり，手技も比較的容易であると考えられた．

A-44-year old female was admitted to our hospital suffering from abdominal pain. Abdominal computed tomography revealed a cystic tumor of the pancreatic body and tail. Diagnosis of mucinous cystadenoma of pan-creas was made by magnetic resonance cholangiopancreatography and endscopic ultrasonography. Laparo-scopically assisted distal pancreatectomy with preservation of the spleen was performed. After the pancreatic body and tail were mobilized by laparoscopic surgery, distal pancreatectomy, preserving the spleen, was per-formed extracorporeally through minilaparotomy.