Pancreatic surgery is one of the most challenging and complex fields in general surgery.While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority o...Pancreatic surgery is one of the most challenging and complex fields in general surgery.While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion.This is attributed to the retroperitoneal location of the pancreas,its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy.Herein,we describe the application of robotic technology to minimally invasive pancreatic surgery.The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes(e.g.,decreased length of stay,less surgical site infections)to conventional open surgery.However,it is unclear whether the robotic approach is truly superior to traditional laparoscopy;this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities.展开更多
Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that ma...Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that may allow their preoperative diagnosis. Histopathology databases of two large pancreatic units were searched to identify LECs and notes reviewed to determine patient demographic details, mode of presentation, investigations, treatment and outcome. Five male and one female patients were identified. Their median age was 60 years. Lesions were identified on computed tomography performed for abdominal pain in two patients, and were incidentally observed in four patients. Five LECs were located in the tail and one in the body of the pancreas, with a median cyst size of 5 cm. Obtaining cyst fluid was difficult and a largely acellular aspirate was yielded. The pre-operative diagnosis was mucinous cystic neoplasm in all patients. This series of patients were treated distal pancreatectomy and splenectomy. A retrospective review of radiological examinations suggested that LECs have a relatively low signal on T2 imaging and a high signal intensity on T1 weighted images. LECs appear more common in elderly males, and are typically incidental, large, unilocular cysts. Close attention to signal intensity on MRI may allow preoperative diagnosis of these lesions.展开更多
文摘Pancreatic surgery is one of the most challenging and complex fields in general surgery.While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion.This is attributed to the retroperitoneal location of the pancreas,its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy.Herein,we describe the application of robotic technology to minimally invasive pancreatic surgery.The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes(e.g.,decreased length of stay,less surgical site infections)to conventional open surgery.However,it is unclear whether the robotic approach is truly superior to traditional laparoscopy;this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities.
文摘Pancreatic lymphoepithelial cysts（LECs） are rare,benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that may allow their preoperative diagnosis. Histopathology databases of two large pancreatic units were searched to identify LECs and notes reviewed to determine patient demographic details, mode of presentation, investigations, treatment and outcome. Five male and one female patients were identified. Their median age was 60 years. Lesions were identified on computed tomography performed for abdominal pain in two patients, and were incidentally observed in four patients. Five LECs were located in the tail and one in the body of the pancreas, with a median cyst size of 5 cm. Obtaining cyst fluid was difficult and a largely acellular aspirate was yielded. The pre-operative diagnosis was mucinous cystic neoplasm in all patients. This series of patients were treated distal pancreatectomy and splenectomy. A retrospective review of radiological examinations suggested that LECs have a relatively low signal on T2 imaging and a high signal intensity on T1 weighted images. LECs appear more common in elderly males, and are typically incidental, large, unilocular cysts. Close attention to signal intensity on MRI may allow preoperative diagnosis of these lesions.
