Laparoscopic omentalization of a pancreatic cyst in a cat
2019
Brückner, Michael
CASE DESCRIPTION A 15-year-old spayed female domestic shorthair cat was examined because of a 1-year history of daily vomiting, which was not associated with food intake. CLINICAL FINDINGS Initial physical examination findings and serial hematologic and serum biochemical results were unremarkable except for the presence of a grade 2/6 left-sided heart murmur and persistent mild azotemia. A well-defined multilobulated cystic structure located between the spleen and left kidney was identified by abdominal ultrasonography. TREATMENT AND OUTCOME Laparoscopic exploration revealed that the cystic structure originated from the left pancreatic limb. With laparoscopic guidance, the structure was percutaneously drained and underwent omentalization. Then, a partial cystectomy was performed to obtain a tissue specimen for histologic evaluation. The vomiting resolved for a short period immediately after surgery and then gradually resumed over 6 months, albeit with less frequency than prior to surgery. The histologic diagnosis was pancreatic cyst. Abdominal ultrasonography performed 6 months after surgery revealed that the original cyst had completely resolved but multiple smaller cysts had developed. The serum feline pancreas-specific lipase activity was not measured before surgery but remained increased from the reference limit following surgery, and chronic pancreatitis was considered the most likely cause of pancreatic cyst formation. CLINICAL RELEVANCE Laparoscopic-guided drainage and omentalization of a large pancreatic cyst resulted in a satisfactory outcome for the cat of this report and can be considered an alternative to percutaneous ultrasound-guided cyst drainage and the more invasive laparotomy approach for pancreatic cystectomy with or without omentalization.
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