Spleen-preserving distal pancreatectomy with splenic vessel preservation: challenges in measuring the learning curve

The use of selective splenic vascular control in laparoscopic splenic vessels and spleen preservation distal pancreatectomy

Background

In the process of laparoscopic splenic vessels and spleen preservation distal pancreatectomy (LsvSPDP), because the splenic blood vessels have many small branches, how to safely separate the splenic blood vessels from the pancreas has always been the focus and difficulty of this operation. Many cases were switched to laparotomy, or the Warshaw method due to the inability to control bleeding during the separation of the splenic blood vessels. Therefore, we tried to use the selective splenic vascular control method when separating the splenic blood vessels to observe its effect on the conditions of the surgical patients during and after the operation.

Methods

We retrospectively collected 35 cases of LsvSPDP conducted in our center from September 2015 to December 2020, including 5 males and 30 females. Considering the influence of the surgical learning curve, the cases were divided into three groups. Finally, through statistics of its intraoperative and postoperative conditions, the effectiveness of selective splenic vascular control method can be judged.

Results

Patients in Group 2 and 3 showed significantly less blood loss (172.5 and 134.44 mL, respectively) compared to patients in Group 1 (541.43 mL; P=0.01). However, the amount of blood loss was not significantly different between Group 2 and 3.

Conclusions

The amount of bleeding was significantly reduced by splenic blood vessel control technology. And it can improve the success rate of spleen preservation, preserve the success rate of splenic blood vessels, and reduce intraoperative bleeding.