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Laparoscopic‐assisted pancreaticoduodenectomy in a child with gastrinoma
Authors:Naruhiko Murase  Hiroo Uchida  Takahisa Tainaka  Hiroshi Kawashima  Yujiro Tanaka  Hizuru Amano  Hiroshi Kishimoto
Affiliation:1. Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya;2. Departments of Pediatric Surgery, Pathology, Saitama Children's Medical Center, Saitama, Japan;3. Department of Pathology, Saitama Children's Medical Center, Saitama, Japan
Abstract:
Gastrinoma is rare in children. We report the case of a 9‐year‐old boy with weight loss and vomiting. Upper gastrointestinal imaging showed severe stenosis of the duodenum. Although gastrin was very high, imaging did not show a gastrinoma. Selective arterial secretagogue injection (SASI) test indicated a tumor within the gastroduodenal arterial zone. In accordance with the SASI test result, we performed laparoscopic‐assisted pancreaticoduodenectomy (LAPD). Postoperative biochemistry confirmed complete resection of the gastrinoma, and the patient was asymptomatic at follow up, 30 months after surgery. Even in patients with negative imaging for gastrinoma, aggressive resection following accurate localization on SASI test is biochemically curative. In such cases, the tumor is probably very small and LAPD may offer a minimally invasive procedure. As far as we know, LAPD in a child has not been previously reported.
Keywords:gastrinoma  laparoscopic‐assisted pancreaticoduodenectomy  pediatric  selective arterial secretagogue injection test
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