Exploration of the safety and feasibility of the preservation of spleen with ligation of splenic vessels / 中华肝胆外科杂志

As an important immune organ,spleen also plays a crucial role in stabilizing hematologic system.Previous reports support that splenectomy must be performed after the ligation of spleen vessels.At recent time,with the deep knowledge of the anatomy and function of spleen,the surgeons have tried to preserve this organ after the ligation of the vessels.From March 2012 to April 2016,five patients in our hospital have undergone the distal pancreatectomy with spleen preservation after the ligation of splenic vessels,and all the patients' outcomes were satisfactory in the follow-up.This essay aims to discuss the safety and feasibility of preserving spleen after the ligation of the vessels by reporting our own experience and reviewing related literatures on this topic.

The left anterior pararenal space approach in laparoscopic distal pancreatectomy with splenic preservation / 中华肝胆外科杂志

Objective To explore the safety of the left anterior pararenal space approach in laparoscopic distal pancreatectomy with splenic preservation.Methods 30 patients operated between August 2008 and September 2013 were retrospectively reviewed.Results Of the 30 patients,28 underwent laparoscopic distal pancreatectomy with preservation of splenic artery and vein,2 underwent laparoscopic distal pancreatectomy with division of the splenic artery and vein and preservation of the short gastric vessels.All the 30 patients had their operations carried out successfully with an average operative time of (55 ± 38) min,blood loss (100 ± 48) ml and duration of hospitalization 7.8 d.Pancreatic fistula occurred in 2 patients and it healed spontaneously on drainage.Partial splenic infarction occurred in 1 patient.The pathological lesions were serous cystadenoma in 6 patients,mucinous cystadenoma in 6 patients,insulinoma in 5 patients,solid pseudopapillary tumor in 6 patients,chronic pancreatitis presenting as a mass in 3 patients,and pancreatic cyst in 4 patients.Conclusions The left anterior pararenal space approach was safe and efficacious in distal pancreatectomy with splenic preservation.If the pancreatic lesion was big and compressed the splenic artery and vein,laparoscopic distal pancreatectomy with division of the splenic artery and vein and preservation of the short gastric vessels was the procedure of choice.