scholarly journals The use of selective splenic vascular control in laparoscopic splenic vessels and spleen preservation distal pancreatectomy

Gland Surgery ◽  
2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Zhe Liu ◽  
Zhihuan Xiao ◽  
Guichen Li ◽  
Anjiang Gou ◽  
Yuanhong Xu ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Vascular Control ◽  
Spleen Preservation ◽  
Splenic Vessels

Laparoscopic Splenic Vessels and Spleen Preservation Distal Pancreatectomy Via Inferior-Posterior Splenic Vein Approach

2020 ◽  
Vol 30 (5) ◽  
pp. 424-429
Author(s):  
Ting Kai Liao ◽  
Chih-Jung Wang ◽  
Ping-Jui Su ◽  
Wei-Hsun Lui ◽  
Ying Jui Chao ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Splenic Vein ◽  
Spleen Preservation ◽  
Splenic Vessels

scholarly journals Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
T. de Rooij ◽  
R. Sitarz ◽  
O. R. Busch ◽  
M. G. Besselink ◽  
M. Abu Hilal
Keyword(s):  
Distal Pancreatectomy ◽  
Malignant Disease ◽  
Laparoscopic Approach ◽  
Laparoscopic Distal Pancreatectomy ◽  
Spleen Preservation ◽  
Multicenter Studies ◽  
Technical Aspects ◽  
Spleen Preserving ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Splenic Vessels

Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving distal pancreatectomy should be attempted in case of benign disease. Spleen preservation can be achieved preferably by preserving the splenic vessels (Kimura technique), but also by resecting the splenic vessels and maintaining vascularity through the short gastric vessels and left gastroepiploic artery (Warshaw technique). Several studies have suggested a higher rate of spleen preservation with laparoscopy. The radical antegrade modular pancreatosplenectomy has become mainstay for treating pancreatic cancer and can be performed laparoscopically as well. Evidence on the feasibility and safety of laparoscopic distal pancreatectomy for cancer is scarce. Despite the obvious advantages of laparoscopic surgery, postoperative morbidity remains relatively high, mainly because of the high incidence of pancreatic fistula. For decades, surgeons have tried to prevent these fistulas but to date no strategy has been confirmed to be effective in 2 consecutive randomized studies. Pragmatic multicenter studies focusing on technical aspects of laparoscopic distal pancreatectomy are lacking and should be encouraged.

scholarly journals Minimally invasive distal pancreatectomy: a case-matched cost-analysis between robot-assisted surgery and direct manual laparoscopy

2021 ◽  
Author(s):  
Gregorio Di Franco ◽  
Andrea Peri ◽  
Valentina Lorenzoni ◽  
Matteo Palmeri ◽  
Niccolò Furbetta ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cost Analysis ◽  
Distal Pancreatectomy ◽  
Length Of Hospital Stay ◽  
High Volume ◽  
Fixed Costs ◽  
Spleen Preservation ◽  
Robotic Assisted Surgery ◽  
The Mean ◽  
Complications Rate

Abstract Background Few studies have reported a structured cost analysis of robotic distal pancreatectomy (RDP), and none have compared the relative costs between the robotic-assisted surgery (RAS) and the direct manual laparoscopy (DML) in this setting. The aim of the present study is to address this issue by comparing surgical outcomes and costs of RDP and laparoscopic distal pancreatectomies (LDP). Methods Eighty-eight RDP and 47 LDP performed between January 2008 and January 2020 were retrospectively analyzed. Three comparable groups of 35 patients each (Si-RDP-group, Xi-RDP group, LDP-group) were obtained matching 1:1 the RDP-groups with the LDP-group. Overall costs, including overall variable costs (OVC) and fixed costs were compared using generalized linear regression model adjusting for covariates. Results The conversion rate was significantly lower in the Si-RDP-group and Xi-RDP-group: 2.9% and 0%, respectively, versus 14.3% in the LDP-group (p = 0.045). Although not statistically significant, the mean operative time was lower in Xi-RDP-group: 226 min versus 262 min for Si-RDP-group and 247 min for LDP-group. The overall post-operative complications rate and the length of hospital stay (LOS) were not significantly different between the three groups. In LDP-group, the LOS of converted cases was significantly longer: 15.6 versus 9.8 days (p = 0.039). Overall costs of LDP-group were significantly lower than RDP-groups, (p < 0.001). At multivariate analysis OVC resulted no longer statistically significantly different between LDP-group and Xi-RDP-group (p = 0.099), and between LDP-group and the RDP-groups when the spleen preservation was indicated (p = 0.115 and p = 0.261 for Si-RDP-group and Xi-RDP-group, respectively). Conclusions RAS is more expensive than DML for DP because of higher acquisition and maintenance costs. The flattening of these differences considering only the variable costs, in a high-volume multidisciplinary center for RAS, suggests a possible optimization of the costs in this setting. RAS might be particularly indicated for minimally invasive DP when the spleen preservation is scheduled.

scholarly journals Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) with Preservation of Splenic Vessels: An Inferior-Posterior Approach

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yong Fei Hua ◽  
Dipesh Kumar Yadav ◽  
Xueli Bai ◽  
Tingbo Liang
Keyword(s):  
Blood Loss ◽  
Distal Pancreatectomy ◽  
Splenic Artery ◽  
Posterior Approach ◽  
Operative Time ◽  
The Other ◽  
Intraoperative Blood Loss ◽  
Spleen Preserving ◽  
Splenic Vessels ◽  
Approach Group

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.

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

Pancreatology ◽  
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

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

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S1018
Author(s):  
R. De Luca ◽  
G. Barile ◽  
C. Cartanese ◽  
E. Grasso ◽  
R. Lomonaco ◽  
...  
Keyword(s):  
Young Patient ◽  
Distal Pancreatectomy ◽  
Spleen Preserving ◽  
Splenic Vessels ◽  
Splenic Vessels Preservation

scholarly journals Laparoscopic distal pancreatectomy with preservation of the splenic vessels

2019 ◽  
Vol 4 ◽  
pp. 98-98
Author(s):  
Viktor Justin ◽  
Sebastian Wisiak ◽  
James Elvis Waha ◽  
Selman Uranues
Keyword(s):  
Distal Pancreatectomy ◽  
Laparoscopic Distal Pancreatectomy ◽  
Splenic Vessels

Robotic distal pancreatectomy: Comparison of spleen-preservation by Warshaw technique and splenectomy

Pancreatology ◽  
2019 ◽  
Vol 19 ◽  
pp. S34
Author(s):  
Yi-Ming Shyr ◽  
Shin-E. Wang
Keyword(s):  
Distal Pancreatectomy ◽  
Spleen Preservation

The straightened splenic vessels method dramatically improves surgical outcomes after laparoscopic distal pancreatectomy

Pancreatology ◽  
2016 ◽  
Vol 16 (4) ◽  
pp. S81
Author(s):  
Chie Takishita ◽  
Yuichi Nagakawa ◽  
Yatsuka Sahara ◽  
Yuichi Hosokawa ◽  
Tetsushi Nakajima ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Surgical Outcomes ◽  
Laparoscopic Distal Pancreatectomy ◽  
Splenic Vessels

Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatectomy

2009 ◽  
Vol 96 (6) ◽  
pp. 633-640 ◽  
Author(s):  
Y.-S. Yoon ◽  
K. H. Lee ◽  
H.-S. Han ◽  
J. Y. Cho ◽  
K. S. Ahn
Keyword(s):  
Distal Pancreatectomy ◽  
Splenic Vessel ◽  
Splenic Vessels
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