INDIVIDUALIZED APPROACH FOR SPLENIC ARTERY IN LAPAROSCOPIC DISTAL PANCREATECTOMY.
Yusuke Wada*, Takeshi Aoki, Akira Fujimori, Tomotake Koizumi, Hideki Shibata, Kodai Tomioka, Takahito Hirai
Department of Gastroenterological Surgery and General Surgery, Showa University, Shinagawa-ku, Japan
[Background] Standard criteria have not been established in the selection of surgical procedures for dissecting splenic artery during LDP, which is mainly classified into two different methods, ventral or dorsal approach. The aim of this study is to evaluate the efficacy and safety of the individualized approach for splenic artery during LDP in accordance with the preoperative imaging studies.
[Methods] Patients who underwent LDP between July 2009 and December 2015 in a single center were retrospectively observed. According to the preoperative three-dimensional (3D) imaging studies, we classified the splenic artery into two major types; Type V that curves and runs ventral to the pancreas, and Type D that runs straight and dorsal of pancreas. The surgical procedure for dissecting the splenic artery was then assigned according to the types of splenic artery variations. Type V was assigned to approach ventrally of the pancreas, Type D was assigned to approach dorsally.
[Results] Thirty patients were applied including 6 males (20%) and 24 females (80%). There were 25 cases (83%) of Type V, whereas Type D was only seen in 5 patients (17%). In 25 patients (83%), the splenic artery was successfully dissected by the surgical procedure that were planned and simulated preoperatively.
[Conclusions] We believe that the individualized approach for splenic artery according to the preoperative 3D imaging studies can be beneficial during LDP.
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