Minimally Invasive Management of Ectopic Pancreas

J Laparoendosc Adv Surg Tech A. 2017 Mar;27(3):277-282. doi: 10.1089/lap.2016.0562. Epub 2017 Jan 25.

Abstract

Background: The management of ectopic pancreas is not well defined. This study aims to determine the prevalence of symptomatic ectopic pancreas and identify those who may benefit from treatment, with a particular focus on robotically assisted surgical management.

Methods: Our institutional pathology database was queried to identify a cohort of ectopic pancreas specimens. Additional clinical data regarding clinical symptomatology, diagnostic studies, and treatment were obtained through chart review.

Results: Nineteen cases of ectopic pancreas were found incidentally during surgery for another condition or found incidentally in a pathologic specimen (65.5%). Eleven patients (37.9%) reported prior symptoms, notably abdominal pain and/or gastrointestinal bleeding. The most common locations for ectopic pancreas were the duodenum and small bowel (31% and 27.6%, respectively). Three out of 29 cases (10.3%) had no symptoms, but had evidence of preneoplastic changes on pathology, while one harbored pancreatic cancer. Over the years, treatment of ectopic pancreas has shifted from open to laparoscopic and more recently to robotic surgery.

Conclusions: Our experience is in line with existing evidence supporting surgical treatment of symptomatic or complicated ectopic pancreas. In the current era, minimally invasive and robotic surgery can be used safely and successfully for treatment of ectopic pancreas.

Keywords: ectopic pancreas; minimally invasive surgery; pancreatic intraepithelial neoplasia; robotic surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Choristoma / diagnosis
  • Choristoma / surgery*
  • Duodenal Diseases / diagnosis
  • Duodenal Diseases / surgery*
  • Follow-Up Studies
  • Humans
  • Laparoscopy*
  • Male
  • Pancreas*
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Treatment Outcome