A Case of Robotic Distal Pancreatectomy Following Chemotherapy for Metastatic Splenic Hilar Lymph Node

A 76-year-old man underwent laparoscopic total gastrectomy for advanced proximal gastric cancer and was diagnosed as pT4aN2M0, pStage ⅢA. Three years postoperatively, abdominal CT revealed a 2-cm mass near the splenic hilum, and further evaluation led to a diagnosis of isolated lymph node recurrence of gastric cancer at the splenic hilum. A total of 11 courses of chemotherapy, including nivolumab combined with SOX regimen, were administered. The lesion remained localized with no new metastases, and surgical resection was planned. Robotic distal pancreatectomy was performed using the da VinciTM SP System. The postoperative course was uneventful, and the patient was discharged on postoperative day 10. Pathological examination confirmed metastatic adenocarcinoma. As of 4 months after surgery, the patient remains recurrence-free. We present this resected oligometastasis case with a review of the relevant literature.