An attempt at enucleating the body lesion was made but was abandoned when it was evident that the lesion would not shell out easily like a typical pancreatic adenoma. The proximity of the vessels on the deep side of the lesion and the probability of injuring the pancreatic duct were factored into the decision.
The splenic vein just distal to the junction of the inferior mesenteric vein was encircled with a vessel loop in preparation for mobilizing the body of the pancreas.
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Venous control was achieved by vessel loops around splenic and superior mesenteric veins. The hepatoduodenal ligament was dissected free so that the portal vein could be easily controlled by a Pringle maneuver. Inferior mesenteric vein was clearly visible for compression if necessary.
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