Comparing the Warshaw technique with vessel-preservation in laparoscopic spleen preserving distal pancreatectomy: is there a better approach?

被引:2
|
作者
Zhu, Alice [1 ,2 ]
Greene, Brittany [1 ,2 ,3 ]
Tsang, Melanie [1 ,2 ,3 ]
Jayaraman, Shiva [1 ,2 ,3 ,4 ,5 ]
机构
[1] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada
[2] Univ Toronto, Div Gen Surg, Toronto, ON, Canada
[3] St Josephs Hlth Ctr, HPB Serv, Unity Hlth Toronto, Toronto, ON, Canada
[4] Li Ka Shing Knowledge Inst, Unity Hlth Toronto, Toronto, ON, Canada
[5] St Josephs Hlth Ctr, 1600 Bloor St, 21, Toronto, ON M6P 1A7, Canada
关键词
SPLENIC PRESERVATION; RESECTION; CONSERVATION; SPLENECTOMY; COMPLICATIONS; BENIGN;
D O I
10.1016/j.hpb.2022.09.016
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) can be accomplished with either resection of the splenic vessels via the Warshaw Technique (WT) or via preservation of the splenic vessels (SVP). Our study aims to compare outcomes for the two methods of LSPDP. Methods: We performed a retrospective chart review with intent-to-treat analysis of adults undergoing LSPDP at a single institution from 2009 to 2021. We compared demographic characteristics, operative parameters, oncologic pathology review, and postoperative outcomes. Results: There were 102 consecutive cases of LSPDP (59 WT, 43 SVP) over 12 years. The rate of successful spleen preservation was not significantly different between the two groups (76.3%WT, 65.1% VSP,p = 0.27). Rates of conversion to laparotomy, postoperative complications including pancreatic fistulas and splenic infarcts and amount of intraoperative blood loss were similar between the groups. Median operative time was significantly shorter with the WT (141 vs. 177 min, p < 0.05). The median length of stay in hospital was not significantly different among the groups. Conclusion: Both techniques are safe and effective in preserving the spleen in laparoscopic distal pancreatectomy. Our experience suggests that the Warshaw Technique may be more efficient with respect to the use of limited operative resources.
引用
收藏
页码:109 / 115
页数:7
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