title: Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.
abstract: Herein, we report the successful performance of a laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for a patient with pancreatic cystadenoma, as a minimally invasive procedure with the preservation of function. The laparoscopy-assisted distal pancreatectomy procedure involved detaching the spleen and the distal pancreas from the retroperitoneum by a hand-assisted procedure, removing them from the peritoneal cavity through a small incision, and detaching the distal pancreas by ligating and transecting the short gastric artery and vein and the branches of the splenic artery and vein, while the spleen and main splenic artery and vein were preserved under direct view. The pancreatic parenchyma was transected with a stapling device (TL-30), and continuous suturing was added to the resected margin. The patient's postoperative course was uneventful; the patient started to eat and walk on postoperative day 2 and was discharged on day 8. It is considered that the combination of hand-assisted and laparoscopy-assisted distal pancreatectomy, with conservation of the splenic artery and vein, is a minimally invasive and clinically useful technique for treating tumors of cystic disease of the pancreas with low-grade malignant potential, or benign solitary neuroendocrine tumors.
authors.affiliation: Department of Surgery, Omori Hospital, Toho University School of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-0015, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
authors.forename: Sumito
authors.initials: S
authors.lastname: Takagi
authors.forename: Naoki
authors.initials: N
authors.lastname: Joubara
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kubota
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Shiba
mesh_terms: D000328:Adult; D003537:Cystadenoma / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D013154:Spleen / Q000601:surgery; D013157:Splenic Artery / Q000601:surgery; D013162:Splenic Vein / Q000601:surgery; D017792:Surgical Stapling