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Laparoscopic spleen-preserving distal pancreatectomy with and without splenic vessel preservation: The role of the Warshaw procedure
- Source :
- Pancreatology. 14:530-535
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Background/objectives: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for low-grade malignant pancreas tumors was recently demonstrated. Although the procedure with splenic vessel preservation (SVP) is optimal for LSPDP, SVP is not always possible in patients with a large tumor or a tumor attached to splenic vessels. This study aimed to analyze the safety of two procedures: LSPDP without SVP, known as the Warshaw technique (lap-WT), and LSPDP with SVP (lap-SVP). Methods: Seventeen patients who underwent a lap-WT and seven patients who underwent a lap-SVP were investigated retrospectively. Results: The median follow-up duration was 45 (range 17-105) months. In the lap-WT and lap-SVP patients, the sizes of the tumors were 5 (1.3-12) and 1.5 (1-4) cm; the operative times were 304 (168-512) and 319 (238-387) min; the blood loss was 210 (5-3250) and 60 (9-210) gr; the length of the postoperative hospital stay was 15 (8-29) and 18 (5-24) days; the peak platelet counts were 37.2 (14.6 -65.2) and 26.4 (18.8-41) × 104/μL, and splenomegaly was observed in 10 (59%) and three (43%) patients, respectively. In both procedures, there was no local recurrence. In the lap-WT group, splenic infarctions were seen in four (24%) patients and perigastric varices were seen in two (12%) patients. All of these patients were observed conservatively. Conclusions: Both the lap-WT and lap-SVP were found to be safe and effective, and in cases in which the tumor is relatively large or close to the splenic vessels, lap-WT can be used as the more appropriate procedure.<br />Pancreatology, 14(6), pp.530-535; 2014
- Subjects :
- Adult
Male
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Blood Loss, Surgical
Splenic vessel preservation
Splenic infarction
Laparoscopic distal pancreatectomy
Pancreatectomy
Postoperative Complications
Blood loss
Pancreatic tumor
medicine
Humans
Aged
Retrospective Studies
Aged, 80 and over
Hepatology
business.industry
digestive, oral, and skin physiology
Gastroenterology
Perigastric
Length of Stay
Middle Aged
medicine.disease
Surgery
Pancreatic Neoplasms
Splenomegaly
Pancreas tumor
Splenic vessel
Blood Vessels
Female
Laparoscopy
Spleen preserving
Warshaw technique
Distal pancreatectomy
business
Varices
human activities
Spleen
Follow-Up Studies
Subjects
Details
- ISSN :
- 14243903
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Pancreatology
- Accession number :
- edsair.doi.dedup.....09d65e7ebd0f80f108de3bf7b02a437e