Laparoscopic spleen-preserving distal pancreatectomy with and without splenic vessel preservation: The role of the Warshaw procedure

Abstract

Background/Objectives: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for low-grade

Robotic-Assisted Approach Improves Vessel Preservation in Spleen-Preserving Distal Pancreatectomy

“…All splenic infarctions occurred after a Warshaw procedure as previously reported by others [36][37][38] . In contrast, clinically relevant splenic infarctions were not observed after the Kimura technique in the presented collective.…”

Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta‐analysis

“…The search strategy yielded 411 articles and we checked the title and abstract of the studies according to the inclusion and exclusion criteria and selected 53 articles. After the full texts of the remaining articles were read, 15 articles were included in the meta-analysis of MI-SPDP versus MI-DPS [13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] and 15 articles were included in the meta-analysis of MI-SVP versus MI-WT [13,23,[31][32][33][34][35][36][37][38][39][40][41][42][43]. Figure 1 shows the flow diagram of study identification and evaluation during the review process.…”

Study on laparoscopic spleen preserving distal pancreatectomy procedures comparing splenic vessel preservation and non-preservation

“…Splenic vessels are resected and the spleen survives via the short gastric and left gastroepiploic vessels (16). Matsushima et al reported on the operative outcomes of 17 cases that underwent Lap-W. Splenic infarctions were observed in four patients (24%) and perigastric varices were observed in two patients (12%) (22). All these patients were observed conservatively.…”

“…All these patients were observed conservatively. Matsushima described the importance of preserving not only the short gastric vessels but also the splenocolic ligament and left gastroepiploic vessels in order to retain the blood supply to the spleen in the Warshaw operation (23), and considered that the laparoscopic method of the Warshaw operation may be a more feasible way to preserve the blood supply to the spleen, since a laparoscopic technique can visualize thinner vessels and can therefore avoid unnecessary vessel treatment (22).…”