Postoperative Hematological Changes after Spleen-Preserving Distal Pancreatectomy with Preservation of the Splenic Artery and Vein

Abstract

Background: The aim of this study was to determine the early postoperative hematological changes after spleen-preserving distal pancreatectomy (SpDP) with preservation of the splenic artery and vein (PSAV). Methods: We reviewed 53 patients who underwent SpDP with PSAV (n = 21) or distal pancreatectomy with splenectomy (DPS; n = 32) for benign or low-grade malignant lesions between July 1998 and June 2010. Red and white blood cell (WBC) count, platelet count, serum hemoglobin, hematocrit, C-reactive protein, albumin level, and clinical factors were compared between the SpDP with PSAV and DPS. Results: There were no significant differences in the patient characteristics between the two groups. Platelet count on postoperative day (POD) 5 and WBC count on POD 3 were significantly higher in the DPS group, and these differences continued to be significant until the 3rd month after surgery. Serum hemoglobin and hematocrit in the 1st month after surgery were also significantly higher in the SpDP with PSAV group. Conclusion: The hematological benefits of SpDP with PSAV include reduction of postoperative hematological abnormalities in the early postoperative phase and recovery of the serum hemoglobin and hematocrit levels in the early postoperative phase.

Robotic distal pancreatectomy: Comparison of spleen‐preservation by the Warshaw technique and splenectomy

“…Significant postoperative thrombocytosis after splenectomy was observed in the RDP-S group but not in RDP-SP. This finding has also been reported in the literature, 21,37 and therefore spleen preservation to avoid thrombocytosis might contribute the prevention of thromboembolic events. However, the blood coagulation power of an 'oriental population' is not similar to that of a Western population.…”

“…Spleen infarction and gastric varices are two concerns after distal pancreatectomy with spleen preservation by the Warshaw technique. The rate of spleen infarction was reported to be 2%–74.3%, the rate of gastric varices 8.1%–52.5% and the rate of perigastric varices 25%–70% . However, they are usually asymptomatic during the post‐operative follow‐up period .…”

“…The rate of spleen infarction was reported to be 2%-74.3%, the rate of gastric varices 8.1%-52.5% and the rate of perigastric varices 25%-70%. 1,20,22,24,32,[37][38][39][40] However, they are usually asymptomatic during the post-operative follow-up period. 1,20,24,32,[37][38][39][40] Although the rate of perigastric varices detected by CT scan was as high as 45%, gastric varices was noted by endoscopy in only 2 patients (6%) after RDP-SP in our series.…”

Laparoscopic spleen-preserving distal pancreatectomy with and without splenic vessel preservation: The role of the Warshaw procedure

“…They described that the postoperative platelet counts increased to maximum levels at 2 weeks after the operation in both patients who underwent an SVP and those who underwent a distal pancreatectomy with splenectomy. Although these early postoperative increases in the platelet count were induced by the inflammatory cytokines after the operations, the platelet counts at 3 months after the distal pancreatectomy with splenectomy were higher compared to those after SVP because of the loss of the spleen (26,27). Therefore, the late prolonged thrombocytosis might be related to the splenic function.…”

Acute Pancreatitis is a Predictive Factor for Malignancy in Mixed or Main Duct Intraductal Papillary Mucinous Neoplasms

“…The prognosis of IPMN is good compared with that of ordinary ductal adenocarcinoma, and organ-sparing surgery such as spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein (Kimura's method [9,10]) may be performed [11][12][13] in carefully selected patients. However, the prognosis for IPMN with an associated invasive carcinoma is poor, and surgery at the high-grade dysplasia (non-invasive carcinoma) stage before the start of invasion is important for improving the outcome [14][15][16].…”