Two Stage Hepatopancreatectomy on Frantz Tumor: A Case Report

Abstract

The solid pseudopapillary pancreatic tumor also called “Frantz tumor”, first described in 1959 by Dr. Frantz Gruber. Part of the classification of cystic neoplasms of the pancreas, it is a condition presented predominantly in young women up to in 90% of cases.

A 24-year-old female patient, with abdominal pain of 3 days, accompanied by nausea, vomiting and abdominal distention. A tomography was performed that identified a lesion with a solid aspect of the pancreatic parenchyma at the level of the tail, in the liver lesions in segments VIII and V. A subtotal pancreatectomy was performed with splenectomy, with biopsy of liver lesions, reporting positive for malignancy. It was decided to perform a right portal vein ligation. In the eight postoperative day, right two staged hepatectomy was completed.

In the postoperative day one of the second surgery, she presented clinical sings compatible with bleeding, it was confirmed with tomography as a hematoma in the surgical bed. Exploratory laparotomy was performed with hematoma drainage. She went to an Intensive Care Unit, where she further evolved without complications.

Postoperative bleeding in patients with hepatectomy varies from 4.2% to 10%, and the reasons described for which it occurs are several. In our case, in relation to bleeding on the surface of the resection, diagnosis and control were accurately performed.

Surgical postoperative bleeding is one of the most frequent operative complications of hepatectomy, so it is necessary to keep it in mind and not prolong its treatment for definitive control.