Ann Surg Treat Res.  2019 Mar;96(3):101-106. 10.4174/astr.2019.96.3.101.

Splenic vessel patency: is it real menace to perform laparoscopic splenic vessel-preserving distal pancreatectomy

• Park DJ
• Han IW
• Han SH
• Han SJ
• You YH
• Rhu YJ
• Heo JS
• Choi SH
• Choi DW

• KMID: 2438685
• DOI: http://doi.org/10.4174/astr.2019.96.3.101

Abstract

PURPOSE
This study compared the patency of the splenic vessels between laparoscopic and open spleen and splenic vessel-preserving distal pancreatectomy.
METHODS
We retrospectively reviewed a database of 137 patients who underwent laparoscopic (n = 91) or open (n = 46) spleen and splenic vessel-preserving distal pancreatectomy at a single institute from 2001 through 2015. Splenic vessel patency was assessed by abdominal computed tomography and classified into three grades according to the degree of stenosis.
RESULTS
The splenic artery patency rate was similar in both groups (97.8 vs. 95.7%, P = 0.779). Also, the splenic vein patency rate was not significantly different between the 2 groups (74.7% vs. 82.6%, P = 0.521). Postoperative wound complication was significantly lower in the laparoscopic group (19.8% vs. 28.3%, P = 0.006), and hospital stay was significantly shorter in the laparoscopic group (7 days vs. 9 days, P = 0.001) than in the open group. Median follow-up periods were 22 months (3.7-96.2 months) and 31.7 months (4-104 months) in the laparoscopic and open groups, respectively.
CONCLUSION
Laparoscopic distal pancreatectomy showed good splenic vessel patency as well as open distal pancreatectomy. For this reason, splenic vessel patency is not an obstacle in performing laparoscopic splenic vessel-preserving distal pancreatectomy.

Keyword

Splenic vein; Splenic artery; Pancreatectomy; Laparoscopy; Vascular patency

MeSH Terms

Constriction, Pathologic
Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Pancreatectomy*
Retrospective Studies
Spleen
Splenic Artery
Splenic Vein
Vascular Patency
Wounds and Injuries

Figure

• 

  Fig. 1 Grade of vessel patency. (A) Grade 0: intact. (B) Grade 1: partial occlusion or thrombosis. (C) Grade 3: total occlusion. Yellow circle: splenic vein.

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