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Minimally Invasive Approach for Spleen-Preserving Distal Pancreatectomy: a Comparative Analysis of Postoperative Complication Between Splenic Vessel Conserving and Warshaw’s Technique

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Spleen-preserving distal pancreatectomy with Warshaw’s technique (WT) was reported to have higher spleen-related complication. The aim of this study was to evaluate the postoperative complication between the splenic vessel-conserving technique (SVC) and the WT when they were performed by the minimally invasive approach.

Methods

From January 2006 to June 2015, data of the patients who had laparoscopic or robotic-assisted spleen-preserving distal pancreatectomy for benign or borderline malignant tumors were retrospectively reviewed. Patients were divided into SVC and the WT group for comparison.

Results

Of the 89 patients who had the spleen-preserving distal pancreatectomy, 63 were SVC, whereas 26 were WT. The CT scans showed that patients who had WT were found to have higher rate of splenic infarction (P < 0.001) and had significantly higher rate of collateral vessel formation at 1 year (P < 0.001). All the splenic infarctions were low grade and asymptomatic which resolved spontaneously. None of the patients with collateral formation experienced gastrointestinal bleeding. The postoperative complication of SVC and WT did not differ significantly.

Conclusion

SVC and WT were found to have comparable outcome. Both techniques can be used to achieve higher spleen-preserving rate.

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Authors and Affiliations

  1. Department of General Surgery, Changi General Hospital, Singapore, Singapore

    Lip Seng Lee

  2. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei Univeristy College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, South Korea

    Ho Kyoung Hwang, Chang Moo Kang & Woo Jung Lee

  3. Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea

    Ho Kyoung Hwang, Chang Moo Kang & Woo Jung Lee

Authors
  1. Lip Seng Lee
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  2. Ho Kyoung Hwang
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  3. Chang Moo Kang
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  4. Woo Jung Lee
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Corresponding author

Correspondence to Chang Moo Kang.

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Lee, L.S., Hwang, H.K., Kang, C.M. et al. Minimally Invasive Approach for Spleen-Preserving Distal Pancreatectomy: a Comparative Analysis of Postoperative Complication Between Splenic Vessel Conserving and Warshaw’s Technique. J Gastrointest Surg 20, 1464–1470 (2016). https://doi.org/10.1007/s11605-016-3141-z

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  • DOI: https://doi.org/10.1007/s11605-016-3141-z

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