Intra-operative color Doppler ultrasonography for assessing splenic blood supply during spleen-preserving distal pancreatectomy: a case report.
A 67 year-old Japanese woman presented with a cystic tumorous lesion, measuring 5 cm in diameter, in the tail of the pancreas. She underwent a spleen-preserving distal pancreatectomy (SPDP), in which the splenic artery and vein were divided because they were involved in scar formation around the lesion. Intra-operative color Doppler ultrasonography (CDUS) confirmed that splenic circulation via collaterals (short gastric and left gastroepiploic vessels) was preserved throughout the salvaged spleen. Histology of the resected specimen showed localized pancreatitis with a pseudocyst without neoplastic tissue. The patient's post-operative course was uneventful with no evidence of splenic failure and she was discharged 20 days after the operation. A literature review suggests that SPDP without preserving the splenic artery and vein may result in failure of the preserved spleen due to inadvertent injury to the remaining collaterals. Based on the experience of our case, we think that intra-operative CDUS is useful for assessing splenic circulation after SPDP with division of the splenic artery and vein.
Sato
Y
Y
First Department of Surgery, Niigata University School of Medicine, Japan.
Shirai
Y
Y
Watanabe
T
T
Saito
Y
Y
Hatakeyama
K
K
D000368:Aged; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D013154:Spleen / Q000098:blood supply* / Q000000981:diagnostic imaging; D013157:Splenic Artery / Q000601:surgery; D013162:Splenic Vein / Q000601:surgery; D018615:Ultrasonography, Doppler, Color