Anatomical Preservation of Pancreatic Ducts in Partial Pancreatectomy: A Case Report of Canine Insulinoma.

Abstract

This case report describes partial pancreatectomy in a dog with insulinoma, emphasizing the role of pancreatic ductal anatomy on surgical planning and postoperative management. A 13 yr old castrated male poodle was evaluated for a pancreatic mass with signs indicative of insulinoma. Imaging showed the mass occupying most of the right pancreatic limb, with its cranial margin just adjacent to the minor duodenal papilla. Although intraoperative visualization was limited by duodenal adhesions, postoperative ultrasonography and histopathology supported anatomical preservation of the accessory pancreatic duct. Histopathologic and immunohistochemical analyses confirmed insulinoma with incomplete surgical margins, prompting adjuvant chemotherapy with imatinib. Initial follow-up revealed maintenance of normoglycemia despite development of pancreatitis. Over time, laboratory findings and clinical signs indicated progressive exocrine insufficiency, with diabetes mellitus diagnosed at 8 mo. The patient survived beyond 16 mo postoperatively without tumor recurrence. This case demonstrates that ductal preservation is anatomically feasible when tumor location permits, although functional preservation may not always follow. It highlights the complexity of balancing oncologic control with pancreatic function. Although surgical management of canine insulinoma is well described, few reports examine the impact of ductal anatomy on surgical decisions and long-term outcomes, underscoring the need for further investigation.