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Revisiting vascular patency after spleen-preserving laparoscopic distal pancreatectomy with conservation of splenic vessels.

Hwang HK, Chung YE, Kim KA, Kang CM, Lee WJ - Surg Endosc (2012)

Bottom Line: A total of five patients (17.2%) showed grade 1 or 2 obliteration in conserved splenic veins.Most patients (82.8%) had patent conserved splenic vein.Four patients (13.8%) eventually developed collateral venous vessels around gastric fundus and reserved spleen, but no spleen infarction was found, and none presented clinical relevant symptoms, such as variceal bleeding.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. DRHHK@yuhs.ac

ABSTRACT

Background: We evaluated vascular patency and potential changes in preserved spleens after laparoscopic spleen-preserving distal pancreatectomy (SPDP) with conservation of both splenic vessels.

Methods: We retrospectively analyzed the patency of conserved splenic vessels in patients who underwent laparoscopic or robotic splenic vessel-conserving SPDP from January 2006 to August 2010. The patency of the conserved splenic vessels was evaluated by abdominal computed tomography and classified into three grades according to the degree of severity.

Results: Among 30 patients with splenic vessel-conserving laparoscopic SPDP, 29 patients with complete follow-up data were included in this study. During the follow-up period (median: 13.2 months), grades 1 and 2 splenic arterial obliteration were observed in one patient each. A total of five patients (17.2%) showed grade 1 or 2 obliteration in conserved splenic veins. Most patients (82.8%) had patent conserved splenic vein. Four patients (13.8%) eventually developed collateral venous vessels around gastric fundus and reserved spleen, but no spleen infarction was found, and none presented clinical relevant symptoms, such as variceal bleeding. There was no statistical difference in vascular patency between the laparoscopic and robotic groups (P > 0.05).

Conclusions: Most patients showed intact vascular patency in conserved splenic vessels and no secondary changes in the preserved spleen after laparoscopic splenic vessel-conserving SPDP.

Show MeSH
Conserved splenic artery patency according to follow-up period. Note that none of the obliterated changes in conserved splenic arteries were resolved to lower grades (G1 or G0) during the follow-up period
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Fig2: Conserved splenic artery patency according to follow-up period. Note that none of the obliterated changes in conserved splenic arteries were resolved to lower grades (G1 or G0) during the follow-up period

Mentions: We did not find any splenic artery obliteration in preoperative CT scans. One case of grade 1 and one case of grade 2 splenic arterial obliteration were observed during the early postoperative period. These vascular obliterations continued to the late postoperative period without change. Twenty-seven patients (93.1%) showed grade 0 patency in conserved splenic artery during the follow-up period (Fig. 2).Fig. 2


Revisiting vascular patency after spleen-preserving laparoscopic distal pancreatectomy with conservation of splenic vessels.

Hwang HK, Chung YE, Kim KA, Kang CM, Lee WJ - Surg Endosc (2012)

Conserved splenic artery patency according to follow-up period. Note that none of the obliterated changes in conserved splenic arteries were resolved to lower grades (G1 or G0) during the follow-up period
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3351607&req=5

Fig2: Conserved splenic artery patency according to follow-up period. Note that none of the obliterated changes in conserved splenic arteries were resolved to lower grades (G1 or G0) during the follow-up period
Mentions: We did not find any splenic artery obliteration in preoperative CT scans. One case of grade 1 and one case of grade 2 splenic arterial obliteration were observed during the early postoperative period. These vascular obliterations continued to the late postoperative period without change. Twenty-seven patients (93.1%) showed grade 0 patency in conserved splenic artery during the follow-up period (Fig. 2).Fig. 2

Bottom Line: A total of five patients (17.2%) showed grade 1 or 2 obliteration in conserved splenic veins.Most patients (82.8%) had patent conserved splenic vein.Four patients (13.8%) eventually developed collateral venous vessels around gastric fundus and reserved spleen, but no spleen infarction was found, and none presented clinical relevant symptoms, such as variceal bleeding.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. DRHHK@yuhs.ac

ABSTRACT

Background: We evaluated vascular patency and potential changes in preserved spleens after laparoscopic spleen-preserving distal pancreatectomy (SPDP) with conservation of both splenic vessels.

Methods: We retrospectively analyzed the patency of conserved splenic vessels in patients who underwent laparoscopic or robotic splenic vessel-conserving SPDP from January 2006 to August 2010. The patency of the conserved splenic vessels was evaluated by abdominal computed tomography and classified into three grades according to the degree of severity.

Results: Among 30 patients with splenic vessel-conserving laparoscopic SPDP, 29 patients with complete follow-up data were included in this study. During the follow-up period (median: 13.2 months), grades 1 and 2 splenic arterial obliteration were observed in one patient each. A total of five patients (17.2%) showed grade 1 or 2 obliteration in conserved splenic veins. Most patients (82.8%) had patent conserved splenic vein. Four patients (13.8%) eventually developed collateral venous vessels around gastric fundus and reserved spleen, but no spleen infarction was found, and none presented clinical relevant symptoms, such as variceal bleeding. There was no statistical difference in vascular patency between the laparoscopic and robotic groups (P > 0.05).

Conclusions: Most patients showed intact vascular patency in conserved splenic vessels and no secondary changes in the preserved spleen after laparoscopic splenic vessel-conserving SPDP.

Show MeSH