Indications and Techniques of Spleen-Preserving Distal Pancreatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Xiangsong ¹ , CHEN Deqin ² , WU Wenguang ³ ,  LIU Yong ⁴ , LIU Yingbin ³

1.Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China;;
2.Department of Surgical Oncology, The Second People’s Hospital of Wenzhou, Wenzhou 325000, Zhejiang Province, China;;
3.Department of General Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China;;
4.Department of General Surgery, Yangzhou No.1 People’s Hospital, Yangzhou 225200, Jiangsu Province, China;

Corresponding author：

LIU Yong, Email: yongliu901112@163.com

Keywords：

Lesion in distal pancreas; Distal pancreatectomy; Spleen-preserving

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ObjectiveTo investigate the feasibility and safety of spleen-preserving distal pancreatectomy (SpDP), and to discuss the indications and techniques of SpDP. MethodsThe clinical data of seven patients underwent SpDP between January 2004 and December 2007 in Xinhua Hospital were analyzed retrospectively. ResultsOut of the seven cases, one case received the SpDP combined with partial splenic vessel resection, while the other cases received the SpDP with splenic vessel preservation. The operation time was (2.93±0.38) h and the intraoperative blood loss was (392.86±109.65) ml. Only one case suffered from pancreatic fistula, who finally recovered after medicine therapy and percutaneous drainage. There was no other complication or operative mortality. The postoperative platelet count was (273±43.76)×109/L and the postoperative hospital stay was (17.86±8.07) d. For six cases of patients, no recurrence and metastasis was found after the followup (49.2±14.4) months （30-72 months）. ConclusionSpDP is a safe and feasible procedure, which is worthy for selected cases such as benign neoplasm of the body and tail of the pancreas.

Citation： WU Xiangsong ,CHEN Deqin,WU Wenguang,LIU Yong,LIU Yingbin. Indications and Techniques of Spleen-Preserving Distal Pancreatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(1): 17-20. doi: Copy

1.	Warshaw AL. Conservation of the spleen with distal pancreatectomy [J]. Arch Surg, 1988, 123(5): 550553.
2.	代文杰, 姜洪池, 乔海泉. 保留脾脏的胰体尾切除术 [J]. 中国实用外科杂志, 2001, 21(4): 245247.
3.	甄作均, 王峰杰. 胰体尾部肿瘤手术切除的相关问题 [J]. 实用医学杂志, 2010, 26(10): 16811683.
4.	谢敏, 王健, 包善华, 等. 保脾胰体尾切除术在胰体尾病变时的应用 [J]. 现代医学, 2009, 37(4): 308309.
5.	刘吉宝, 郭予, 魏毓龙. 20例胰体尾癌的外科治疗体会 [J]. 医学论坛杂志, 2006, 27(14): 4445.
6.	翟刚, 李强. 保留脾脏的胰体尾癌切除术18例 [J]. 肿瘤研究与临床, 2009, 21(8): 482483.
7.	刘骞, 邵永孚, 王成峰, 等. 保留脾脏的胰体尾癌切除14例分析 [J]. 中华肝胆外科杂志, 2005, 11(4): 248249.
8.	Shoup M, Conlon KC, Klimstra D, et al. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? [J]. J Gastrointest Surg, 2003, 7(8): 946952.
9.	邱应和, 刘也夫, 姜小清, 等. 胰体尾癌的外科治疗 [J]. 中华胰腺病杂志, 2008, 8(4): 272273.
10.	Lillemoe KD, Kaushal S, Cameron JL, et al. Distal pancreatectomy: indications and outcomes in 235 patients [J]. Ann Surg, 1999, 229(5): 693700.
11.	Benoist S, Dugué L, Sauvanet A, et al. Is there a role of preservation of the spleen in distal pancreatectomy? [J]. J Am Coll Surg, 1999, 188(3): 255260.
12.	Shoup M, Brennan MF, McWhite K, et al. The value of splenic preservation with distal pancreatectomy [J]. Arch Surg, 2002, 137(2): 164168.
13.	Carrère N, Abid S, Julio CH, et al. Spleenpreserving distal pancreatectomy with excision of splenic artery and vein: a casematched comparison with conventional distal pancreatectomy with splenectomy [J]. World J Surg, 2007, 31(2): 375382.
14.	Lee SE, Jang JY, Lee KU, et al. Clinical comparison of distal pancreatectomy with or without splenectomy [J]. J Korean Med Sci, 2008, 23(6): 10111014.
15.	Kimura W, Yano M, Sugawara S, et al. Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein: techniques and its significance [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 813823.
16.	Miura F, Takada T, Asano T, et al. Gastric varices occurring after middlesegment pancreatectomy preserving spleen with division of splenic artery and vein [J]. Surgery, 2004, 135(6): 696697.
17.	Miura F, Takada T, Asano T, et al. Hemodynamic changes of splenogastric circulation after spleenpreserving pancreatectomy with excision of splenic artery and vein [J]. Surgery, 2005, 138(3): 518522.
18.	Tien YW, Liu KL, Hu RH, et al. Risk of varices bleeding after spleenpreserving distal pancreatectomy with excision of splenic artery and vein [J]. Ann Surg Oncol, 2010, 17(8): 21932198.

1. Warshaw AL. Conservation of the spleen with distal pancreatectomy [J]. Arch Surg, 1988, 123(5): 550553.
2. 代文杰, 姜洪池, 乔海泉. 保留脾脏的胰体尾切除术 [J]. 中国实用外科杂志, 2001, 21(4): 245247.
3. 甄作均, 王峰杰. 胰体尾部肿瘤手术切除的相关问题 [J]. 实用医学杂志, 2010, 26(10): 16811683.
4. 谢敏, 王健, 包善华, 等. 保脾胰体尾切除术在胰体尾病变时的应用 [J]. 现代医学, 2009, 37(4): 308309.
5. 刘吉宝, 郭予, 魏毓龙. 20例胰体尾癌的外科治疗体会 [J]. 医学论坛杂志, 2006, 27(14): 4445.
6. 翟刚, 李强. 保留脾脏的胰体尾癌切除术18例 [J]. 肿瘤研究与临床, 2009, 21(8): 482483.
7. 刘骞, 邵永孚, 王成峰, 等. 保留脾脏的胰体尾癌切除14例分析 [J]. 中华肝胆外科杂志, 2005, 11(4): 248249.
8. Shoup M, Conlon KC, Klimstra D, et al. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? [J]. J Gastrointest Surg, 2003, 7(8): 946952.
9. 邱应和, 刘也夫, 姜小清, 等. 胰体尾癌的外科治疗 [J]. 中华胰腺病杂志, 2008, 8(4): 272273.
10. Lillemoe KD, Kaushal S, Cameron JL, et al. Distal pancreatectomy: indications and outcomes in 235 patients [J]. Ann Surg, 1999, 229(5): 693700.
11. Benoist S, Dugué L, Sauvanet A, et al. Is there a role of preservation of the spleen in distal pancreatectomy? [J]. J Am Coll Surg, 1999, 188(3): 255260.
12. Shoup M, Brennan MF, McWhite K, et al. The value of splenic preservation with distal pancreatectomy [J]. Arch Surg, 2002, 137(2): 164168.
13. Carrère N, Abid S, Julio CH, et al. Spleenpreserving distal pancreatectomy with excision of splenic artery and vein: a casematched comparison with conventional distal pancreatectomy with splenectomy [J]. World J Surg, 2007, 31(2): 375382.
14. Lee SE, Jang JY, Lee KU, et al. Clinical comparison of distal pancreatectomy with or without splenectomy [J]. J Korean Med Sci, 2008, 23(6): 10111014.
15. Kimura W, Yano M, Sugawara S, et al. Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein: techniques and its significance [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 813823.
16. Miura F, Takada T, Asano T, et al. Gastric varices occurring after middlesegment pancreatectomy preserving spleen with division of splenic artery and vein [J]. Surgery, 2004, 135(6): 696697.
17. Miura F, Takada T, Asano T, et al. Hemodynamic changes of splenogastric circulation after spleenpreserving pancreatectomy with excision of splenic artery and vein [J]. Surgery, 2005, 138(3): 518522.
18. Tien YW, Liu KL, Hu RH, et al. Risk of varices bleeding after spleenpreserving distal pancreatectomy with excision of splenic artery and vein [J]. Ann Surg Oncol, 2010, 17(8): 21932198.

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