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Robotic spleen preserving distal pancreatectomy
in pediatric patient.
Case report
Young Ju Hong M.D., Seonae Ryu, Hye Kyung Chang M.D., Jung Tak Oh M.D., Seok Joo Han M.D.
Department of Pediatric SurgerySeverance Children`s Hospital
Department of SurgeryYonsei University College of Medicine
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Yonsei University Health System
BackgroundSolid papillary neoplasm rare pancreatic neoplasm (1~3% of primary pancreatic tu-
mors) >80% : female, 85% : less than 30 years old With surgical complete excision 5 YSR : 95 % Aggressive variants : represent malignant degeneration in
an otherwise indolent tumor Surgical resection is indicated in all instances
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Yonsei University Health System
BackgroundMinimally invasive surgery for pancreatic tumor 1996 first laparoscopic distal pancreatectomy Low grade tumor, young patient : choice Splenic preservation : useful, especially in children
da Vinci robot system 3D magnified field of view Precise and multi-articulated handlike motions Hand-tremor filtering system Ergonomically designed operative space
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Case – History of illness
F/16 C.C : low abdominal pain
(duration : 2 weeks) Laboratory test
4800(33%) 12.5/37.4 308K
Amylase/lipase 74/25CEA 0.91CA 19-9 1.5
Yonsei University Health System
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Case – MRI
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Case – MRI
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Case – PET CT
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Case – Operation
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Case – Pathology Solid pseudopapillary tu-
mor– size : 1x0.8cm– Mitosis : 3/10 HPF– LVI : not identified– Resection margin : free from tumor
IH stain– Vimentin and beta-catenin
: positive – CD 10 : focally and weakly
positive– Chromogranin A : Negative
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Case – Progress POD 2 : gas out(+), SOW POD 4 : soft diet POD 5 : Lab : WNL, CT POD 8 : discharge
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Robotic spleen preserving distal pancreatectomy in pediatric patient
Safe Feasible treatment option that preserves splenic function
for benign or low grade malignant tumor of the distal pancreas
Yonsei University Health System
Conclusion
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Thank you for your attention