Laparoscopic spleen-preserving distal pancreatectomy with splenic vessels preservation for pNET in a young patient

Objective. To summarize the operation experience of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with preservation of splenic vessels by an inferior-posterior dissection of the pancreatic body and evaluate its feasibility. Methods. Patients undergoing LSPDS at Ningbo Li Huili Hospital and Ningbo Li Huili Eastern Hospital from January 2014 to April 2017 were recruited in this study and were analyzed retrospectively. They were divided into two groups based on the surgical approach: the inferior-posterior approach group and the other approach group. We sought to compare outcomes of the two groups. Results. The LSPDP procedure was completed successfully in 49 cases, and 48 patients had their splenic artery and vein preserved, including 26 cases in the inferior-posterior approach group and 22 cases in the other approach group. There were no significant differences between the two groups with respect to age (p=0.18), sex (p=0.56), preoperative diabetes (p=1.00), ASA grading (p=1.00), tumor size (p=0.91), intraoperative blood loss (t=−0.01, p=0.99), hospital stay (t=−0.02, p=0.98), and pancreatic fistula rates (p=1.00). Patients undergoing LSPDP by the inferior-posterior approach had a shorter operative time (t=−4.13, p<0.001) than the other approach group. Conclusions. LSPDS by the inferior-posterior approach associated with shorter operative time is safe and feasible.

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Laparoscopic distal pancreatectomy with or without splenectomy: Spleen and splenic vessels preservation does not increase morbidity

Pancreatology ◽

10.1016/j.pan.2016.06.093 ◽

2016 ◽

Vol 16 (4) ◽

pp. S23

Author(s):

Kazuhiro Suzumura ◽

Toshihiro Okada ◽

Yasukane Asano ◽

Hisashi Kosaka ◽

Tadamichi Hirano ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Laparoscopic Distal Pancreatectomy ◽

Splenic Vessels ◽

Splenic Vessels Preservation

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Warshaw Technique in Laparoscopic Spleen-Preserving Distal Pancreatectomy: Surgical Strategy and Late Outcomes of Splenic Preservation

BioMed Research International ◽

10.1155/2019/4074369 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Lei Wang ◽

Dong Wu ◽

Yu-gang Cheng ◽

Jian-wei Xu ◽

Hai-bo Chu ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Splenic Abscess ◽

Healthy Population ◽

Low Grade ◽

Efficient Treatment ◽

Spleen Preserving ◽

Significant Difference ◽

Splenic Vessels

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.

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