To investigate the feasibility and safety of laparoscopic total pancreatectomy combined with splenectomy.

Clinical data of one patient undergoing laparoscopic total pancreatectomy combined with splenectomy in First People's Hospital of Foshan in July 2017 were retrospectively analyzed. The female patient, aged 53 years, was hospitalized due to multiple cystic masses in the whole pancreas found by physical examination for one week. The patient was diagnosed with intraductal mucinous papilloma of the pancreas. The informed consent of the patient was obtained and the local ethical committee approval was received. Laparoscopic total pancreatectomy combined with splenectomy was performed with five-port approach. Multiple cystic change in the pancreas and tight adhesion between cauda pancreatis and splenic vein were observed. After the pancreatic neck was cut off, distal pancreatectomy combined with splenectomy and pancreaticoduodenectomy were performed. Finally, the common hepatic duct-jejunal end-to-side anastomosis and stomach-jejunostomy were performed.

The operation was successfully conducted. The operation time was 8.5 h and the intraoperative bleeding was 250 ml. Postoperatively, insulin was administered to strictly control the glucose level and pancreatin was supplemented to promote digestion. No perioperative complication except temporary delayed gastric emptying was noted. Postoperative pathological examination revealed serous microcystadenoma. The length of postoperative hospital stay was 28 d. After discharge, insulin was injected subcutaneously to control the glucose level and trypsin was orally taken to promote digestion. During postoperative 6-month follow-up, the glucose was controlled at stable level without other complications.

Laparoscopic total panpancreatectomy combined with splenectomy is safe and feasible for pan-pancreatic diseases. The glucose level should be properly controlled and the pancreatin should be supplemented after operation.