Distal pancreatectomy with splenic preservation: A short-term outcome analysis of the Warshaw technique
| Autor: | Federica Burattini, Alessia Corsi, Elisa Castellani, Alban Cacurri, Giuseppe Noya, Nicola Avenia, Amilcare Parisi, Alberto Santoro, Claudio Renzi, Carlo Boselli, Jacopo Desiderio, Veronica Grassi, Roberto Cirocchi, Chiara Listorti, Francesco Barberini, Daniele Pironi, Stefano Trastulli |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment preservation retrospective study Splenectomy Outcome analysis Distal pancreatectomy surgical technique varicosis Article Medium term computer assisted tomography Pancreatectomy adult aged clinical article female human male operation duration operative blood loss pancreas resection priority journal splenic preservation treatment outcome warshaw technique Splenic preservation Warshaw technique medicine Postoperative results Humans Laparoscopy Retrospective Studies medicine.diagnostic_test business.industry Retrospective cohort study General Medicine Middle Aged Surgery Pancreatic Neoplasms Radiology Varices business Spleen |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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