| Distal pancreatectomy with preservation of the spleen. | |
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MedLine Citation:
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PMID: 19882099 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Distal pancreatectomy (resection of the pancreatic body and tail) can be performed with or without preservation of the spleen. Splenic preservation has the advantages of fewer postoperative complications such as abscesses in the resection bed, shorter length of hospitalization, and avoidance of the long-term risk of post-splenectomy sepsis related to encapsulated bacteria. Two techniques can be used to save the spleen: either by dissecting out the splenic artery and vein with division of the arterial and venous branches between the pancreas and the splenic artery and vein; or by resecting the splenic artery and vein along with the pancreas but with careful preservation of the vascular collaterals in the splenic hilum, which allows the spleen to survive on the short gastric vessels (Warshaw technique). The latter method has been shown to be associated with a shorter operation, less blood loss, and a shorter hospitalization. In general the Warshaw technique is easier, especially for laparoscopic pancreatectomy. The subsequent appearance of enlarged gastric veins (varices) is to be expected as a consequence of loss of the splenic vein but has not led to bleeding from these natural collaterals during long-term follow up. |
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Authors:
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Andrew L Warshaw |
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Publication Detail:
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Type: Journal Article; Review Date: 2009-10-31 |
Journal Detail:
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Title: Journal of hepato-biliary-pancreatic sciences Volume: 17 ISSN: 1868-6982 ISO Abbreviation: J Hepatobiliary Pancreat Sci Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-08-24 Completed Date: 2011-01-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101528587 Medline TA: J Hepatobiliary Pancreat Sci Country: Japan |
Other Details:
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Languages: eng Pagination: 808-12 Citation Subset: IM |
Affiliation:
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Department of Surgery, Massachusetts General Hospital, 55 Fruit St., WHT506, Boston, MA 02114-2696, USA. awarshaw@partners.org. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Pancreatectomy / methods* Pancreatic Neoplasms / surgery* Spleen / blood supply*, surgery Splenectomy / methods Splenic Artery / surgery Splenic Vein / surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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