Document Detail

Spleen-preserving distal pancreatectomy for intraductal papillary-mucinous tumor (IPMT).
MedLine Citation:
PMID:  15011836     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Recently, the significance of preserving the spleen has received a lot of attention. Since our first trial and success of spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for chronic pancreatitis, this procedure has been more frequently performed and reported. In this study, we introduce the technique and indications for the procedure for intraductal papillary mucinous tumor of the pancreas. METHODOLOGY: Nine patients underwent spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. We performed this procedure in two patients with intraductal papillary mucinous tumor. The splenic vein is identified behind the pancreas and within the thin connective tissue membrane. The connective tissue membrane is cut longitudinally above the splenic vein. An important technique is to remove the splenic vein from the pancreas from the body of the pancreas toward the spleen. There are many branches from the splenic vein on both sides, and these branches should be carefully ligated and cut. The pancreas is removed from the splenic artery from the spleen toward the head of the pancreas. This procedure is much easier than removing the pancreas from the vein. RESULTS: The postoperative course was uneventful in all nine cases, but one, in which pancreatic fistula continued for more than several weeks. The mean and standard deviation of the operative blood loss, the duration of the operation and the postoperative hospital stay in seven cases, excluding two cases, in which either Puestow's procedure or simultaneous subtotal esophagectomy was performed, were 413+/-385 mL, 298+/-55 min, and 39+/-15 days, respectively. Severe complications were not found in any of the nine cases. The two patients with intraductal papillary mucinous tumor have been followed as outpatients without any recurrence. CONCLUSIONS: Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein is easy and safe, and should be performed for some of the patients with intraductal papillary mucinous tumor of the pancreas.
Wataru Kimura; Akira Fuse; Ichirou Hirai; Koichi Suto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  51     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2004 Jan-Feb
Date Detail:
Created Date:  2004-03-11     Completed Date:  2004-06-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  86-90     Citation Subset:  IM    
First Department of Surgery, Yamagata University School of Medicine, Yamagata City, Yamagata, Japan.
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MeSH Terms
Carcinoma, Pancreatic Ductal / secretion,  surgery*
Cystadenoma, Mucinous / surgery*
Cystadenoma, Papillary / surgery*
Middle Aged
Mucins / secretion
Pancreatectomy / methods*
Pancreatic Neoplasms / surgery*
Reg. No./Substance:

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