Abstract
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.
Highlights
Pancreatic surgery is considered as one of the most challenging surgical procedures in abdominal surgery [1]
We found that female patients made up the majority of the cases in either Warshaw technique (WT) or splenic vessels preservation (SVP) group
The mean tumor size in Warshaw patients was 4.1 ± 1.6 cm, which was much larger than that in the SVP patients (2.9 ± 1.6 cm) (p
Summary
Pancreatic surgery is considered as one of the most challenging surgical procedures in abdominal surgery [1]. Some anatomic disadvantages, such as complex proximity to the major vasculature and retroperitoneal location, have once restrained the application of laparoscopic techniques in pancreas area [2]. With the advances in surgical skills and laparoscopy instruments, laparoscopic distal pancreatectomy (LDP) has been widely utilized for the treatment of benign lesions or low-grade malignancies in the body and tail of the pancreas [3]. Did patients benefit from minimal invasive and enhanced recovery after surgery, their long-term life quality was significantly improved after laparoscopic spleen-preserving distal pancreatectomy (LSPDP) [7]
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