Distal pancreatectomy with splenic preservation: A short-term outcome analysis of the Warshaw technique

作者：Boselli Carlo; Barberini Francesco; Listorti Chiara; Castellani Elisa; Renzi Claudio^*; Corsi Alessia; Grassi Veronica; Cacurri Alban; Desiderio Jacopo; Trastulli Stefano; Santoro Alberto; Pironi Daniele; Burattini Federica; Cirocchi Roberto; Avenia Nicola; Noya Giuseppe; Parisi Amilcare

来源：International Journal of Surgery, 2015, 21: S40-S43.

DOI：10.1016/j.ijsu.2015.06.051

• Distal pancreatectomy
• Splenic preservation
• Warshaw technique

Introduction: Spleen-preserving left pancreatectomy (SPDP) with splenic vessels preservation (SVP) or without (Warshaw technique, WT) has been described with robotic, laparoscopy and open surgery. Nevertheless, significant data on medium-and long-term follow-up are still not available, since data in literature are scarce and the level of evidence is low.
Methods: In this retrospective study, we describe and compare short and medium term results of spleen-preserving distal pancreatectomy in eight patients.
Results: In WT group the duration and the intraoperative bleeding was superior than SVP group. The incidence of perigastric collateral vessels and presence of submucosal varices evidenced at CT scan was 66% in WT group, while only one case occurred in SVP group.
Discussion: The limit of laparoscopic approach is the fact that it needs advanced laparoscopic skills, which might result in intraoperative bleeding and splenectomy. The most of literature considered salvage WT intraoperatively performed in case of classical SVP and not only elective WT. The consequence is that there is no difference in immediate postoperative results (operative time, intraoperative bleeding, hospital stay) that are in favour of SVP because WT is performed only in case of failure in preserving the splenic vessels. In fact when this intervention is performed electively, the procedure time is reduced as well as the intraoperative bleeding.
Conclusions: WT is safe and feasible, even if there are not definitive evidences that demonstrate it is superior to classic SVP. RCTs are needed to determine advantages and disadvantages of WT compared to the classic SVP.

• 出版日期2015-9