Laparoscopic spleen-preserving distal pancreatectomy: Is the Warshaw technique safe?

Purpose:Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) was performed for the patients with benign or low-grade malignant tumors recently. The purpose of this study was to compare laparoscopic splenic vessel preservation (Lap-SVP) with laparoscopic Warshaw technique (Lap-WT) in the safety and outcome of patients undergoing LSPDP.Methods:Thirteen patients underwent a Lap-SVP and four patients underwent a Lap-WT. Their clinical data and outcomes of two procedures were compared by statistical analysis and reviewed retrospectively. Results:Intraoperative blood loss and splenic infarction were higher in the Lap-WT than in the Lap-SVP group. The change ratio of platelet counts at peak, 1, 3, 6, and 12 months after operation in Lap-SVP and Lap-WT were 1.57and 2.29, 1.07 and 1.34, 0.94 and 1.4, 0.95 and 1.17, and 1.04 and 1.3. The change ratio of splenic volume at 1, 6, and 12 months after operation in Lap-SVP and Lap-WT were 1.3 and 1.59, 1.13 and 1.12, and 1.21 and 1.08. There was no postoperative bleeding, portal system thrombosis, perigastric varices, local recurrence and re-operation. All of the patients with splenic infarction could be observed without any treatment.Conclusion:Lap-WT is a safe and feasible option for benign or low-grade malignant tumors in the distal pancreas.