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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

Authors
 Lip Seng Lee  ;  Ho Kyoung Hwang  ;  Chang Moo Kang  ;  Woo Jung Lee 
Citation
 Journal of Gastrointestinal Surgery, Vol.20(8) : 1464-1470, 2016 
Journal Title
 Journal of Gastrointestinal Surgery 
ISSN
 1091-255X 
Issue Date
2016
MeSH
Adult ; Aged ; Female ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects* ; Minimally Invasive Surgical Procedures/methods* ; Pancreatectomy/adverse effects* ; Pancreatectomy/methods* ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery* ; Postoperative Complications* ; Precancerous Conditions/surgery ; Retrospective Studies ; Robotic Surgical Procedures ; Spleen/surgery ; Splenic Artery/surgery ; Splenic Vein/surgery ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Spleen-preserving distal pancreatectomy ; Splenic infarction ; Warshaw’s technique
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.
Full Text
http://link.springer.com/article/10.1007%2Fs11605-016-3141-z
DOI
10.1007/s11605-016-3141-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151661
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