Laparoscopic management of intraductal oncocytic papillary neoplasm of the pancreas: Two case reports and review of literature.

Background: Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is an extremely rare pancreatic tumor, with only sporadic cases reported in the literature. IOPN is difficult to diagnose and highly prone to misdiagnosis. IOPN carries a certain risk of progressing to invasive cancer. Surgical resection is the primary treatment for IOPN. According to the existing literature reports, the vast majority of patients with IOPN of the pancreas undergo open surgery, while only one case of laparoscopic surgery have been reported.

Case summary: This report presents two cases of IOPN in elderly female patients, aged 60 and 61. Both patients were asymptomatic, and their pancreatic masses were discovered incidentally. Preoperative diagnosis of IOPN is challenging and prone to misdiagnosis. In the first case, the patient underwent a laparoscopic distal pancreatectomy and splenectomy. The surgical procedure spanned 342 minutes, with an estimated intraoperative blood loss of around 100 mL. The patient experienced an uneventful postoperative recovery and was discharged on the 8^th postoperative day. For the second case, a laparoscopic pancreaticoduodenectomy was performed. The operation lasted for 431 minutes with an intraoperative blood loss of approximately 50 mL. The patient also demonstrated a favorable postoperative course and was discharged on the 24^th postoperative day. Postoperative pathology and immunohistochemistry confirmed the diagnosis of IOPN. No recurrence was observed in either patient after follow-up periods of 8 and 10 months, respectively.

Conclusion: These cases demonstrate that laparoscopic surgery can be considered as one of the treatment options for IOPN of the pancreas.