Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatectomy

Background: This study evaluated the short‐ and long‐term patency of preserved splenic vessels after laparoscopic spleen‐preserving distal pancreatectomy (SPDP) with preservation of the splenic vessels. Methods: This single‐centre retrospective study included all patients who had undergone splenic v...

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Bibliographic Details
Published in:British journal of surgery 2009-06, Vol.96 (6), p.633-640
Main Authors: Yoon, Y.-S., Lee, K. H., Han, H.-S., Cho, J. Y., Ahn, K. S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Child
Digestive system. Abdomen
Endoscopy
Epidemiologic Methods
Female
General aspects
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy
Length of Stay
Male
Medical sciences
Middle Aged
Pancreatectomy - methods
Pancreatectomy - standards
Pancreatic Neoplasms - surgery
Postoperative Complications
Spleen - blood supply
Spleen - surgery
Splenic Artery - physiology
Splenic Vein - physiology
Tomography, X-Ray Computed
Treatment Outcome
Vascular Patency - physiology
Young Adult
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Summary:Background: This study evaluated the short‐ and long‐term patency of preserved splenic vessels after laparoscopic spleen‐preserving distal pancreatectomy (SPDP) with preservation of the splenic vessels. Methods: This single‐centre retrospective study included all patients who had undergone splenic vessel‐preserving laparoscopic SPDP between 2004 and 2007. The patency of the splenic vessels was assessed by abdominal computed tomography and classified into three grades according to the degree of stenosis. Results: Twenty‐two patients were included. The preoperative patency of the splenic artery and vein was normal in 20 and 19 patients respectively. Normal patency of the splenic artery and vein was observed in 16 and five patients respectively within 1 month of surgery, and in 19 and nine patients 6 months or more after operation. Nine of ten patients with complete splenic vein occlusion developed a collateral circulation in the late postoperative phase. Splenic perfusion was well preserved in all patients. Conclusion: Splenic vessel‐preserving laparoscopic SPDP has the short‐term benefit of good perfusion to the spleen. In the long term, there is a risk of left‐sided portal hypertension if the splenic vein becomes occluded after surgery. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Long‐term follow‐up is needed
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.6609