Limits...
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 vein patency according to follow-up period. Similar to the splenic artery, note that none of the obliterated vessels were resolved to lower grades (G1 or G0) during follow-up period, but one additional patient developed G2 venous obliteration later during the follow-up period
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3351607&req=5

Fig3: Conserved splenic vein patency according to follow-up period. Similar to the splenic artery, note that none of the obliterated vessels were resolved to lower grades (G1 or G0) during follow-up period, but one additional patient developed G2 venous obliteration later during the follow-up period

Mentions: There was no splenic vein obliteration on the preoperative CT scan. During the early postoperative period, grades 1 and 2 splenic vein obliteration were observed in three and one patients, respectively. During the follow-up period, these changes in vascular obliteration continued to the late postoperative period, but one additional patient with grade 0 patency in the early period developed grade 2 obliteration in the conserved splenic vein. Finally, a total of five patients (17.2%, three of grade 1 and two of grade 2) showed partial or complete obliteration in the conserved splenic vein. Twenty-four patients (86.2%) showed grade 0 patency in the conserved splenic vein during the follow-up period (Fig. 3).Fig. 3


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 vein patency according to follow-up period. Similar to the splenic artery, note that none of the obliterated vessels were resolved to lower grades (G1 or G0) during follow-up period, but one additional patient developed G2 venous obliteration later during the follow-up period
© Copyright Policy
Related In: Results  -  Collection

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

Fig3: Conserved splenic vein patency according to follow-up period. Similar to the splenic artery, note that none of the obliterated vessels were resolved to lower grades (G1 or G0) during follow-up period, but one additional patient developed G2 venous obliteration later during the follow-up period
Mentions: There was no splenic vein obliteration on the preoperative CT scan. During the early postoperative period, grades 1 and 2 splenic vein obliteration were observed in three and one patients, respectively. During the follow-up period, these changes in vascular obliteration continued to the late postoperative period, but one additional patient with grade 0 patency in the early period developed grade 2 obliteration in the conserved splenic vein. Finally, a total of five patients (17.2%, three of grade 1 and two of grade 2) showed partial or complete obliteration in the conserved splenic vein. Twenty-four patients (86.2%) showed grade 0 patency in the conserved splenic vein during the follow-up period (Fig. 3).Fig. 3

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