INTRODUCTION: Portal annular pancreas (PAP) is a rare congenital anatomical variation, first reported in 1987, characterized by an uncinate process encircling the portal vein and fusing with the pancreatic body. While often asymptomatic, the presence of PAP poses a significant technical challenge during pancreatectomy because of its altered anatomy and the elevated risk of postoperative pancreatic fistula (POPF). Consensus is lacking on the optimal pancreatic transection method (1- or 2-cut margin approach) to minimize this complication. We report the first documented case of robot-assisted distal pancreatectomy (DP) for pancreatic cancer in a patient with PAP, highlighting a novel surgical strategy for pancreatic division.
Noso et al. (Thu,) studied this question.