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Pancreatico-duodenectomy (Whipple procedure)

Intraductal papillary mucinous neoplasm (IPMN) and invasive mucinous carcinoma with preservation of the 1st jejunal branch of the superior mesenteric vein (SMV)

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  • Case Scenario

    • A 62 year old woman was referred for management of the incidental finding of a 1.5 cm solid and cystic lesion in the head of the pancreas.
    • Staging CT scans suggested interval growth to 2cm.
    • EUS and aspiration yielded a complex lesion with both cystic and solid components, not typical of a serous cystadenoma. FNA yielded 'atypical cells in a mucinous background'.
    • Working diagnosis was an Intraductal Papillary Mucinous Neoplasm (IPMN). Because of the apparent growth and solid components, resection was recommended. A pancreatico-duodenectomy (Whipple procedure) was planned.
  • CT scans

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  • Pathology (images courtesy of Dr. Oyedele Adeyi)

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