Laparoscopic distal pancreatectomy with spleen preservation
Epublication WebSurg.com, Jun 2016;16(06). URL: http://websurg.com/doi/lt03encury001
Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. Nowadays, more than 80% of distal pancreatectomies are performed laparoscopically. The basic advantages of this approach over the open approach are the following: reduced blood loss, fewer complications, and shorter hospital stay. Pancreatic neoplasms, chronic pancreatitis, and pancreatic cysts are the main indications for laparoscopic distal pancreatectomy. Distal pancreatosplenectomy and spleen-preserving pancreatectomy are contraindicated in metastatic diseases, peritoneal carcinosis, vascular invasion, and pancreatitis involving the entire pancreas. Spleen-preserving distal pancreatectomy should be attempted in case of benign disease. Spleen preservation should preferably be achieved by preserving the splenic vessels (Kimura technique), but also by resecting the splenic vessels and maintaining vascularity through the short gastric vessels and the left gastroepiploic artery (Warshaw’s technique).