Preoperative Glucagon‐Like Peptide‐1 Receptor Agonist Treatment to Allow Safe Laparoscopic Left Pancreatectomy in Extreme Obesity: The First Report

TL;DR

A patient with extreme obesity successfully underwent pancreatic surgery after using a weight-loss drug to reduce surgical risks.

Contribution

First report of using a glucagon-like peptide-1 receptor agonist to safely enable laparoscopic left pancreatectomy in extreme obesity.

Findings

Six months of glucagon-like peptide-1 receptor agonist treatment reduced BMI from 56 to 48.

Laparoscopic left splenopancreatectomy was successfully performed in a patient with extreme obesity.

The patient remained healthy 17 months post-surgery with continued weight loss.

Abstract

Obesity is a challenging condition for pancreatic surgery, and some authors recommend delaying pancreatic resection for non‐malignant pancreatic tumors in obese patients. We present a case of a 45‐year‐old woman with a body mass index (BMI) of 56 who was surgically treated in our department for a mucinous cystadenoma discovered during preoperative work‐up for bariatric surgery. To decrease the risk involved in pancreatic surgery, a glucagon‐like peptide‐1 receptor agonist was administered for 6 months, which led to a weight loss of 20 kg and a BMI of 48 at the time of surgery. A laparoscopic left splenopancreatectomy was performed within 7 months of the diagnosis. The postoperative length of stay was 19 days. Pathology confirmed that the tumor was mucinous cystadenoma with mild dysplasia. As of 17 months later, the patient is doing well and has lost an additional 10 kg.

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