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Distal pancreatectomy with splenic preservation: A short-term outcome analysis of the Warshaw technique
- Publication Year :
- 2015
-
Abstract
- Introduction Spleen-preserving left pancreatectomy (SPDP) with splenic vessels preservation (SVP) or without (Warshaw technique, WT) has been described with robotic, laparoscopy and open surgery. Nevertheless, significant data on medium- and long-term follow-up are still not available, since data in literature are scarce and the level of evidence is low. Methods In this retrospective study, we describe and compare short and medium term results of spleen-preserving distal pancreatectomy in eight patients. Results In WT group the duration and the intraoperative bleeding was superior than SVP group. The incidence of perigastric collateral vessels and presence of submucosal varices evidenced at CT scan was 66% in WT group, while only one case occurred in SVP group. Discussion The limit of laparoscopic approach is the fact that it needs advanced laparoscopic skills, which might result in intraoperative bleeding and splenectomy. The most of literature considered salvage WT intraoperatively performed in case of classical SVP and not only elective WT. The consequence is that there is no difference in immediate postoperative results (operative time, intraoperative bleeding, hospital stay) that are in favour of SVP because WT is performed only in case of failure in preserving the splenic vessels. In fact when this intervention is performed electively, the procedure time is reduced as well as the intraoperative bleeding. Conclusions WT is safe and feasible, even if there are not definitive evidences that demonstrate it is superior to classic SVP. RCTs are needed to determine advantages and disadvantages of WT compared to the classic SVP.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
preservation
retrospective study
Splenectomy
Outcome analysis
Distal pancreatectomy
surgical technique
varicosis
Article
Medium term
computer assisted tomography
Pancreatectomy
adult
aged
clinical article
female
human
male
operation duration
operative blood loss
pancreas resection
priority journal
splenic preservation
treatment outcome
warshaw technique
Splenic preservation
Warshaw technique
medicine
Postoperative results
Humans
Laparoscopy
Retrospective Studies
medicine.diagnostic_test
business.industry
Retrospective cohort study
General Medicine
Middle Aged
Surgery
Pancreatic Neoplasms
Radiology
Varices
business
Spleen
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....07342954d5d38c5bf212ec5760ae7021