This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (136)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Andrew L. Warshaw, MD

Arch Surg. 1988;123(5):550-553.

Abstract
• This report describes a rapid, easy, and safe means of saving the spleen while resecting or fully mobilizing the pancreatic tail. The pancreas is separated from the spleen by dividing the splenic artery and vein distal to the tip of the pancreas. The spleen survives on the short gastric vessels, which are carefully preserved. The technique has been applied successfully in 22 of 25 consecutive patients with chronic pancreatitis (n=13), acute pancreatitis and pancreatic necrosis (n=3), cystic neoplasm of the pancreas (n=4), islet cell tumor (n=2), and ductal adenocarcinoma (n=3). The spleen could not be saved in three patients because of splenic hilar involvement by tumor or scar. Normal postoperative blood cell counts and spleen scans proved splenic viability and function. There was only one complication, a late splenic abscess that developed in a spleen of twice-normal size. It is concluded that in most instances the distal pancreas can be mobilized for resection or inspection without the need for splenectomy. Splenomegaly may be a contraindication because the short-vessel gastric blood supply may be inadequate to nourish the increased tissue mass. The technique is applicable to the treatment of pancreatic tumors, trauma, and pancreatitis.

(Arch Surg 1988;123:550-553)

Author Affiliations
From the Surgical Services of the Massachusetts General Hospital and the Department of Surgery, Harvard Medical School, Boston.

Footnotes
Accepted for publication Jan 27, 1988.

Read before the Annual Meeting of the New England Surgical Society, Bretton Woods, NH, Sept 13, 1987.

Reprint requests to Massachusetts General Hospital, ACC 336, 15 Parkman St, Boston, MA 02114 (Dr Warshaw).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Single-Institution Prospective Study of Laparoscopic Pancreatic Resection
Sa Cunha et al.
Arch Surg 2008;143:289-295.
ABSTRACT | FULL TEXT  

Cost-Reduction Model for Treatment of Pancreatic Leak Following Distal Pancreatectomy
Badruddoja
Arch Surg 2006;141:1267-1267.
FULL TEXT  

Implications and Cost of Pancreatic Leak Following Distal Pancreatic Resection
Rodriguez et al.
Arch Surg 2006;141:361-366.
ABSTRACT | FULL TEXT  

Laparoscopic Distal Pancreatomy: Are We Ready for a Standardized Technique?
Pietrabissa et al.
SURG INNOV 2004;11:179-183.
ABSTRACT  

The Value of Splenic Preservation With Distal Pancreatectomy
Shoup et al.
Arch Surg 2002;137:164-168.
ABSTRACT | FULL TEXT  

Postobstructive Chronic Pancreatitis: Results With Distal Resection
Sakorafas et al.
Arch Surg 2001;136:643-648.
ABSTRACT | FULL TEXT  

Ten-Year Experience With 733 Pancreatic Resections: Changing Indications, Older Patients, and Decreasing Length of Hospitalization
Balcom IV et al.
Arch Surg 2001;136:391-398.
ABSTRACT | FULL TEXT  

Laparoscopic Pancreatic Resections
Cuschieri and Jakimowicz
SURG INNOV 1998;5:168-179.
ABSTRACT  

Middle Segment Pancreatectomy: A Novel Technique for Conserving Pancreatic Tissue
Warshaw et al.
Arch Surg 1998;133:327-331.
ABSTRACT | FULL TEXT  

Standards for Pancreatic Resection in the 1990s
Castillo et al.
Arch Surg 1995;130:295-300.
ABSTRACT  

Conservation of the Spleen With Distal Pancreatectomy
SUTHERLAND and NAJARIAN
Arch Surg 1988;123:1525-1525.
ABSTRACT