Total Pancreatectomy [Case 24]


This is a 67 year old man who initially presented with weight loss. His initial ultrasound and subsequent CT scan demonstrated a very large pancreatic duct and a cyst in the pancreas. He had an endoscopic ultrasound which showed thickened septi in the pancreatic cyst. A fine needle aspirate was done and confirmed for mucinous cyst, suggesting IPMN (intraductal papillary mucinous neoplasm).

In addition, an ERCP revealed a fish mouth papilla with mucus coming out of it. His main pancreatic duct is dilated (1.7cm) in the head. The complex cystic mass measures approximately 3.4 x 3.1cm on axial imaging. The pancreatic body appears to have additional small cysts or side branches. There is no suspected vascular invasion, and no biliary dilatation.

Our plan is to prepare for a total pancreatectomy. He has also been consented for a splenectomy just in case.

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