Perioperative and long-term results of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels conservation: A retrospective analysis

2011 ◽  
Vol 105 (4) ◽  
pp. 387-392 ◽  
Author(s):  
Giovanni Butturini ◽  
Marco Inama ◽  
Giuseppe Malleo ◽  
Riccardo Manfredi ◽  
Gian Luigi Melotti ◽  
...  
2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Lei Wang ◽  
Dong Wu ◽  
Yu-gang Cheng ◽  
Jian-wei Xu ◽  
Hai-bo Chu ◽  
...  

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.


HPB ◽  
2017 ◽  
Vol 19 (4) ◽  
pp. 345-351 ◽  
Author(s):  
D. Louis ◽  
A. Alassiri ◽  
S. Kirzin ◽  
S. Blaye-Felice ◽  
M. Chalret du Rieu ◽  
...  

2019 ◽  
Vol 58 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Caroline Dana ◽  
Zagorka Péjin ◽  
Céline Cadilhac ◽  
Philippe Wicart ◽  
Christophe Glorion ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yong Fei Hua ◽  
Dipesh Kumar Yadav ◽  
Xueli Bai ◽  
Tingbo Liang

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.


HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S1018
Author(s):  
R. De Luca ◽  
G. Barile ◽  
C. Cartanese ◽  
E. Grasso ◽  
R. Lomonaco ◽  
...  

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.


2019 ◽  
Vol 36 (2) ◽  
pp. 6-13
Author(s):  
V. N. Barykov ◽  
A. G. Istomin ◽  
R. R. Abdrashitov ◽  
A. S. Ryzhikh

Aim. To assess the results of distal pancreatectomy for malignant and benign tumors and chronic pancreatitis complications. Materials and methods. Forty-seven patients, who underwent distal pancreatectomy, were under observation during the period from 01.01.2008 to 28.02.2019. Results. The long-term results of surgical treatment demonstrated the following complications: pancreatic fistulas – 15 % of observations, pancreatogenic diabetes mellitus – 12.7 %, subphrenic abscesses – 10 %. In the long-term period after the surgery – from 10 years and not less than one year – 30 patients were followed up, constituting 63.8 % of the total number. Conclusions. To prevent complications in the form of pancreatic fistula with pathological Wirsung duct dilatation more than 4–5 mm in diameter, it is necessary to form anastomosis between the pancreatic stump and the small bowel.


2020 ◽  
pp. 030089162093674
Author(s):  
Michele Mazzola ◽  
Jacopo Crippa ◽  
Camillo L. Bertoglio ◽  
Sara Andreani ◽  
Lorenzo Morini ◽  
...  

Introduction: Outcomes after distal pancreatectomy with or without splenectomy are controversial. The present study aims to investigate differences in short-term and long-term outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). Methods: In this retrospective review of consecutive patients undergoing distal pancreatectomy with or without splenectomy from January 2011 until December 2017 for benign disease, the primary endpoint was to compare postoperative pancreatic fistula (POPF). The secondary endpoint was to compare duration of surgery, intraoperative blood loss, postoperative complications, length of hospital stay, and long-term outcomes. Results: Patients undergoing SPDP had a lower rate of POPF (13.6% vs 46.1%; p = 0.02). Patients undergoing SPDP (n = 22) were discharged earlier than patients undergoing DPS (n = 26) (8 [4–29] vs 12 [6.48] days; p = 0.003). No differences in other intraoperative and postoperative outcomes were found between groups. Conclusion: Patients undergoing SPDP developed fewer POPF and were discharged earlier compared to patients undergoing DPS.


Pancreatology ◽  
2019 ◽  
Vol 19 ◽  
pp. S129
Author(s):  
Viacheslav Egorov ◽  
Roman Petrov ◽  
Kristina Dmitrieva ◽  
Dmitry Ionkin ◽  
Natalia Starostina

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