Perioperative and Long-term Outcome of the Warshaw Technique in Laparoscopic Spleen-preserving Distal Pancreatectomy

Surg Laparosc Endosc Percutan Tech. 2017 Dec;27(6):474-478. doi: 10.1097/SLE.0000000000000484.

Abstract

Purpose: The purpose of this study was to compare the safety and outcomes of laparoscopic splenic vessel preservation (Lap-SVP) to those of laparoscopic Warshaw technique (Lap-WT).

Materials and methods: Fourteen patients underwent Lap-SVP and 5 patients underwent Lap-WT. Their clinical data and outcomes of the 2 procedures were compared.

Results: The operative time, intraoperative blood loss, clinically relevant pancreatic fistula, and the rate of splenic infarction were significantly higher in the patients who underwent Lap-WT than in those who underwent Lap-SVP. In both groups, the platelet count ratio and splenic volume ratio at 1 month after the operation did not differ from the preoperative values. Two patients in the Lap-WT group experienced splenic infarction, and could be observed without any treatment.

Conclusions: The long-term outcome of Lap-WT was relevant. Therefore, Lap-WT could be a treatment option for patients who may not have undergone Lap-SVP.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / epidemiology*
  • Spleen
  • Splenic Artery
  • Splenic Vein
  • Time Factors
  • Treatment Outcome
  • Young Adult