[Distal pancreatectomy with "centrifugal" dissection of splenic vessels].
We describe a technique of distal pancreatectomy beginning with division of pancreatic neck before control of splenic vessels. Early neck division allows safer vascular control. For distal pancreatectomy, primary section of the neck and splenic vessels ligation, combined with division of left gastro-epiploic and short gastric vessels, precedes mobilization of a devascularized specimen, decreases operative bleeding and seems more logical from a carcinologic point of view. Furthermore, this technique could be the first step of left pancreatectomy with splenic preservation.
Goasguen
N
N
Service de chirurgie digestive, hôpital Beaujon, AP-HP, université Paris VII, 100, boulevard du Gal-Leclerc, 92118 Clichy cedex, France.
Regimbeau
J M
JM
Sauvanet
A
A
D016063:Blood Loss, Surgical / Q000517:prevention & control; D002908:Chronic Disease; D004210:Dissection / Q000379:methods*; D006801:Humans; D008026:Ligation / Q000379:methods; D009017:Morbidity; D010180:Pancreatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000601:surgery; D010195:Pancreatitis / Q000601:surgery; D018579:Patient Selection; D013154:Spleen / Q000098:blood supply* / Q000601:surgery; D013156:Splenectomy / Q000379:methods; D013157:Splenic Artery / Q000601:surgery*; D013162:Splenic Vein / Q000601:surgery*