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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
Perigastric collateral vessels according to follow-up period. There seems to be a time lag between the development of perigastric collateral vessels and splenic vein obliteration, but most patients with splenic vein obliteration developed perigastric collateral vessels during the late follow-up period (4/5 patients). Note that one additional patient with newly developed splenic venous obliteration (G2) showed G2 perigastric collateral vessels during the late follow-up period, suggesting that long-term follow-up should be considered for patients with splenic vessel-conserving SPDP
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Fig4: Perigastric collateral vessels according to follow-up period. There seems to be a time lag between the development of perigastric collateral vessels and splenic vein obliteration, but most patients with splenic vein obliteration developed perigastric collateral vessels during the late follow-up period (4/5 patients). Note that one additional patient with newly developed splenic venous obliteration (G2) showed G2 perigastric collateral vessels during the late follow-up period, suggesting that long-term follow-up should be considered for patients with splenic vessel-conserving SPDP

Mentions: Four patients (13.8%, one of grade 1 and three of grade 2) eventually developed collateral venous vessels around the gastric fundus and reserved spleen. However, no spleen infarction was found, and none presented clinically relevant symptoms, such as variceal bleeding during the follow-up period (Fig. 4).Fig. 4


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)

Perigastric collateral vessels according to follow-up period. There seems to be a time lag between the development of perigastric collateral vessels and splenic vein obliteration, but most patients with splenic vein obliteration developed perigastric collateral vessels during the late follow-up period (4/5 patients). Note that one additional patient with newly developed splenic venous obliteration (G2) showed G2 perigastric collateral vessels during the late follow-up period, suggesting that long-term follow-up should be considered for patients with splenic vessel-conserving SPDP
© Copyright Policy
Related In: Results  -  Collection

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

Fig4: Perigastric collateral vessels according to follow-up period. There seems to be a time lag between the development of perigastric collateral vessels and splenic vein obliteration, but most patients with splenic vein obliteration developed perigastric collateral vessels during the late follow-up period (4/5 patients). Note that one additional patient with newly developed splenic venous obliteration (G2) showed G2 perigastric collateral vessels during the late follow-up period, suggesting that long-term follow-up should be considered for patients with splenic vessel-conserving SPDP
Mentions: Four patients (13.8%, one of grade 1 and three of grade 2) eventually developed collateral venous vessels around the gastric fundus and reserved spleen. However, no spleen infarction was found, and none presented clinically relevant symptoms, such as variceal bleeding during the follow-up period (Fig. 4).Fig. 4

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