Gastric bleeding risk following spleen preserving distal pancreatectomy with excision of the splenic vessels: a long-term follow-up

Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) can be accomplished with either the preservation or the resection of splenic vessels; the latter is also known as Warshaw technique. Our study is designed to investigate the operation selection strategy when proceeding LSPDP and to evaluate the long-term outcomes of patients undergoing Warshaw surgery. The medical records and follow-up data of patients who underwent LSPDP in Qilu Hospital, Shandong University, were reviewed retrospectively. A total of thirty-five patients were involved in this study, including 17 cases of patients who were treated with Warshaw procedure (WT) while the other 18 cases had splenic vessels preserved (SVP). Compared with the SVP group, the operative time and intraoperative blood loss in WT group were improved significantly. The incidence of early postoperative splenic infarction was higher in WT group. However, there was no report of splenic abscess or second operation. Follow-up data confirmed that there was no significant difference in spleen phagocytosis and immune function compared with normal healthy population. Our study confirms that LSPDP-Warshaw procedure is a safe and efficient treatment for the benign or low grade malignant tumors in distal pancreas in selected patients. The long-term spleen function is normal after Warshaw procedure. Preoperative assessment and intraoperative exploration are recommended for the selection of operation approaches.

Download Full-text

Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

10.21203/rs.3.rs-27080/v2 ◽

2020 ◽

Author(s):

Ren-Chao Zhang ◽

Jun Ma ◽

yiping mou ◽

Yu-Cheng Zhou ◽

Wei-Wei Jin ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Neuroendocrine Neoplasms ◽

Transfusion Rate ◽

Long Term Outcomes ◽

Pancreatic Neuroendocrine Neoplasms ◽

Spleen Preserving ◽

Short And Long Term ◽

Organ Sparing

Abstract Background：Pancreatic neuroendocrine neoplasms (PNENs) are rare neoplasms associated with a long life expectancy after resection. In this setting, patients may benefit from laparoscopic organ-sparing resection. Studies of laparoscopic organ-sparing resection for PNENs are limited. The aim of this study was to evaluate the short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs.Methods： A retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses and morbidity, mortality, and follow-up data (until August 2018) were analysed.Results：Thirty-five patients were included in the final analysis. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3 kg/m2. Nine patients received laparoscopic enucleation (LE), 20 received laparoscopic spleen-preserving distal pancreatectomy (LSPDP), and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, and postoperative hospital stay were 186.4±60.2 min, 165±73.0 ml, 0 d, and 9 d (range, 5-23 d), respectively. The morbidity rate, grade ≥III complication rate and grade ≥B pancreatic fistula rate were 34.2%, 11.4%, and 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158 months). One patient developed recurrence 36 months after LE and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up. One patient had diabetes after laparoscopic spleen-preserving distal pancreatectomy, and no patients had symptoms of pancreatic exocrine insufficiency. Conclusions： Laparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible and has favourable short- and long-term outcomes.

Download Full-text

Comparative erythrocyte deformability investigations by filtrometry, slit-flow and rotational ektacytometry in a long-term follow-up animal study on splenectomy and different spleen preserving operative techniques: Partial or subtotal spleen resection and spleen autotransplantation

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-160231 ◽

2017 ◽

Vol 66 (1) ◽

pp. 83-96 ◽

Cited By ~ 3

Author(s):

Iren Miko ◽

Norbert Nemeth ◽

Viktoria Sogor ◽

Ferenc Kiss ◽

Eniko Toth ◽

...

Keyword(s):

Animal Study ◽

Erythrocyte Deformability ◽

Operative Techniques ◽

Spleen Preserving ◽

Slit Flow ◽

Long Term Follow Up

Download Full-text

Perioperative and long-term results of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels conservation: A retrospective analysis

Journal of Surgical Oncology ◽

10.1002/jso.22117 ◽

2011 ◽

Vol 105 (4) ◽

pp. 387-392 ◽

Cited By ~ 48

Author(s):

Giovanni Butturini ◽

Marco Inama ◽

Giuseppe Malleo ◽

Riccardo Manfredi ◽

Gian Luigi Melotti ◽

...

Keyword(s):

Retrospective Analysis ◽

Distal Pancreatectomy ◽

Long Term Results ◽

Spleen Preserving ◽

Splenic Vessels

Download Full-text

Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

10.21203/rs.3.rs-20636/v1 ◽

2020 ◽

Author(s):

Renchao Zhang ◽

Jun Ma ◽

Yi-Ping Mou ◽

Yu-Cheng Zhou ◽

Wei-Wei Jin ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Neuroendocrine Neoplasms ◽

Long Term Outcomes ◽

Pancreatic Neuroendocrine Neoplasms ◽

Spleen Preserving ◽

Short And Long Term ◽

Organ Sparing ◽

Laparoscopic Enucleation

Abstract BackgroundPancreatic neuroendocrine neoplasms (PNENs) are rare neoplasm with long life expectancy. In this setting, patients may benefit from laparoscopic organ-sparing resection. There are few reports of laparoscopic organ-sparing resection for PNENs. The aim of this study was to evaluate the Short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs.MethodsA retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data (including pancreatic function, till August 2018) was analyzed.ResultsThirty-five patients were identified. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3kg/m2. Nine patients received laparoscopic enucleation, 20 received laparoscopic spleen-preserving distal pancreatectomy, and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, postoperative hospital stay were 186.4±60.2min, 165±73.0ml, 0, 9d(range, 5-23d), respectively. The morbidity rate, ≥Grade Ⅲ complication rate and ≥grade B pancreatic fistula rate were 34.2%, 11.4%, 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158months). One patients had diabetes after laparoscopic spleen-preserving distal pancreatectomy, no patient had symptom of pancreatic exocrine insufficiency. One patient developed recurrence 36 months after laparoscopic enucleation and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up.ConclusionsLaparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible, and have favorable short- and long-term outcome.

Download Full-text

Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

10.21203/rs.3.rs-27080/v1 ◽

2020 ◽

Author(s):

Ren-Chao Zhang ◽

Jun Ma ◽

yiping mou ◽

Yu-Cheng Zhou ◽

Wei-Wei Jin ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Neuroendocrine Neoplasms ◽

Long Term Outcomes ◽

Pancreatic Neuroendocrine Neoplasms ◽

Spleen Preserving ◽

Short And Long Term ◽

Organ Sparing ◽

Laparoscopic Enucleation

Abstract Background Pancreatic neuroendocrine neoplasms (PNENs) are rare neoplasm with long life expectancy. In this setting, patients may benefit from laparoscopic organ-sparing resection. There are few reports of laparoscopic organ-sparing resection for PNENs. The aim of this study was to evaluate the Short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs. Methods A retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data (including pancreatic function, till August 2018) was analyzed. Results Thirty-five patients were identified. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3kg/m 2 . Nine patients received laparoscopic enucleation, 20 received laparoscopic spleen-preserving distal pancreatectomy, and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, postoperative hospital stay were 186.4±60.2min, 165±73.0ml, 0, 9d(range, 5-23d), respectively. The morbidity rate, ≥Grade III complication rate and ≥grade B pancreatic fistula rate were 34.2%, 11.4%, 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158months). One patients had diabetes after laparoscopic spleen-preserving distal pancreatectomy, no patient had symptom of pancreatic exocrine insufficiency. One patient developed recurrence 36 months after laparoscopic enucleation and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up. Conclusions Laparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible, and have favorable short- and long-term outcome.

Download Full-text

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Download Full-text