Serous cystic neoplasm: Do we have to wait till it causes trouble? Season 2

A 50-year-old male presented gradually growing pancreatic body mass. An abdominal computed tomography showed a 9.9-cm mass, larger than the 8.9-cm mass one year ago. As the patient did not have complaints for any symptomatic problems, the gastroenterologist decided to check it with regular follow-up. However, as the tumor grew faster than expected, the patient was recommended for surgical resection. Laparoscopic pylorus preserving pancreaticoduodenectomy was done. Since the tumor abutted to the superior mesenteric vein and the portal vein, wedge resection of vessel was inevitable. Pathology was serous cystadenoma. The patient was discharged without postoperative complications. Herein, we report this case with asymptomatic large serous cystic neoplasm treated by laparoscopic approach. The appropriateness of current guidelines for surgery in serous cystic neoplasm is also discussed.