Document Detail

Distal pancreatectomy with preservation of the spleen.
MedLine Citation:
PMID:  19882099     Owner:  NLM     Status:  MEDLINE    
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.
Andrew L Warshaw
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-10-31
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic sciences     Volume:  17     ISSN:  1868-6982     ISO Abbreviation:  J Hepatobiliary Pancreat Sci     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528587     Medline TA:  J Hepatobiliary Pancreat Sci     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  808-12     Citation Subset:  IM    
Department of Surgery, Massachusetts General Hospital, 55 Fruit St., WHT506, Boston, MA 02114-2696, USA.
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MeSH Terms
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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