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Pancreaticoduodenectomy in portal annular pancreas: report of a case

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Abstract

Portal annular pancreas (PAP) is a rare anatomical anomaly in which the pancreatic parenchyma surrounds the superior mesenteric vein and portal vein (PV) annularly. This anomaly requires careful consideration in pancreatic resection. A case is presented and the technical issues are discussed. A 61-year-old female was referred to the hospital for suspected papilla Vater adenocarcinoma. Preoperative computed tomography showed that the PV was annularly surrounded by pancreatic parenchyma. Surgery revealed the uncinate process extended extensively behind the PV and fused with the pancreatic body. The pancreas was first divided above the PV, and it was divided again in the body after liberating the PV from pancreatic annulation. The postoperative course was uneventful without pancreatic fistula. It is safer to divide the pancreatic body on the left of the fusion between the uncinate process and the pancreatic body to reduce the risk of pancreatic fistula in pancreaticoduodenectomy for PAP.

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Conflict of interest

Shin Kobayashi and other co-authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 18-22 Honkomagome 3-chome, Bunkyo-ku, Tokyo, Japan, 113-8677

    Shin Kobayashi, Goro Honda, Masanao Kurata, Yukihiro Okuda & Koji Tsuruta

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  1. Shin Kobayashi
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  2. Goro Honda
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  3. Masanao Kurata
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  4. Yukihiro Okuda
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  5. Koji Tsuruta
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Correspondence to Shin Kobayashi.

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Kobayashi, S., Honda, G., Kurata, M. et al. Pancreaticoduodenectomy in portal annular pancreas: report of a case. Surg Today 43, 926–929 (2013). https://doi.org/10.1007/s00595-012-0280-z

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  • DOI: https://doi.org/10.1007/s00595-012-0280-z

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