Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatectomy.
BACKGROUND
This study evaluated the short- and long-term patency of preserved splenic vessels after laparoscopic spleen-preserving distal pancreatectomy (SPDP) with preservation of the splenic vessels.


METHODS
This single-centre retrospective study included all patients who had undergone splenic vessel-preserving laparoscopic SPDP between 2004 and 2007. The patency of the splenic vessels was assessed by abdominal computed tomography and classified into three grades according to the degree of stenosis.


RESULTS
Twenty-two patients were included. The preoperative patency of the splenic artery and vein was normal in 20 and 19 patients respectively. Normal patency of the splenic artery and vein was observed in 16 and five patients respectively within 1 month of surgery, and in 19 and nine patients 6 months or more after operation. Nine of ten patients with complete splenic vein occlusion developed a collateral circulation in the late postoperative phase. Splenic perfusion was well preserved in all patients.


CONCLUSIONS
Splenic vessel-preserving laparoscopic SPDP has the short-term benefit of good perfusion to the spleen. In the long term, there is a risk of left-sided portal hypertension if the splenic vein becomes occluded after surgery. (c) 2009 British Journal of Surgery Society Ltd.
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Gyeonggi-do, Korea.
Y-S
YS
Yoon
K H
KH
Lee
H-S
HS
Han
J Y
JY
Cho
K S
KS
Ahn
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods* / Q000592:standards; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D013154:Spleen / Q000098:blood supply* / Q000601:surgery; D013157:Splenic Artery / Q000502:physiology; D013162:Splenic Vein / Q000502:physiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*; D055815:Young Adult