title: Minimally Invasive Approach for Spleen-Preserving Distal Pancreatectomy: a Comparative Analysis of Postoperative Complication Between Splenic Vessel Conserving and Warshaw's Technique.
abstract: Spleen-preserving distal pancreatectomy with Warshaw's technique (WT) was reported to have higher spleen-related complication. The aim of this study was to evaluate the postoperative complication between the splenic vessel-conserving technique (SVC) and the WT when they were performed by the minimally invasive approach.
  
  
  
  From January 2006 to June 2015, data of the patients who had laparoscopic or robotic-assisted spleen-preserving distal pancreatectomy for benign or borderline malignant tumors were retrospectively reviewed. Patients were divided into SVC and the WT group for comparison.
  
  
  
  Of the 89 patients who had the spleen-preserving distal pancreatectomy, 63 were SVC, whereas 26 were WT. The CT scans showed that patients who had WT were found to have higher rate of splenic infarction (P < 0.001) and had significantly higher rate of collateral vessel formation at 1 year (P < 0.001). All the splenic infarctions were low grade and asymptomatic which resolved spontaneously. None of the patients with collateral formation experienced gastrointestinal bleeding. The postoperative complication of SVC and WT did not differ significantly.
  
  
  
  SVC and WT were found to have comparable outcome. Both techniques can be used to achieve higher spleen-preserving rate.
authors.affiliation: Department of General Surgery, Changi General Hospital, Singapore, Singapore.
authors.forename: Lip Seng
authors.initials: LS
authors.lastname: Lee
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei Univeristy College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, South Korea.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea.
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei Univeristy College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, South Korea. cmkang@yuhs.ac.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea. cmkang@yuhs.ac.
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei Univeristy College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, South Korea.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea.
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011230:Precancerous Conditions / Q000601:surgery; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D013154:Spleen / Q000601:surgery; D013157:Splenic Artery / Q000601:surgery; D013162:Splenic Vein / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Spleen-preserving distal pancreatectomy; Splenic infarction; Warshaw’s technique