ROBOTIC DISTAL PANCREATECTOMY WITH SPLEEN PRESERVATION

Male patient, 40 years old, previously healthy, reports abdominal pain for 1 year, with no other associated complaints. Magnetic nuclear resonance identifies a solid-cystic lesion in the pancreas tail, 3.8 cm on the longest axis, communicating with the main pancreatic duct, associated with parenchymal atrophy and Wirsung duct dilatation. Suspicious image for Intraductal papillary mucinous neoplasm (IPMN). Patient with ASA II anesthetic risk, without previous abdominal surgery, normal physical examination. Tumor markers such as CA 19.9 and CEA were normal. There weren t changes on pancreatic enzymes. We performed a robotic distal pancreatectomy with spleen preservation. Uneventful procedure, no postoperative surgical complications, discharged on the 4th postoperative day. Definitive pathology confirming the diagnosis of intraductal mucinous neoplasia, 3.2 cm in the longest axis, with high-grade dysplasia. Free surgical margins, without lymph node involvement. Final clinical staging: pTispN0.