Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy.

Abstract:

BACKGROUND:There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT). METHODS:Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using an suprapancreatic approach and type D using a dorsal approach. RESULTS:Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery. CONCLUSION:The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.

journal_name

BMC Surg

journal_title

BMC surgery

authors

Wada Y,Aoki T,Murakami M,Fujimori A,Koizumi T,Kusano T,Matsuda K,Nogaki K,Hakozaki T,Shibata H,Tomioka K

doi

10.1186/s12893-020-00694-y

subject

Has Abstract

pub_date

2020-02-13 00:00:00

pages

32

issue

1

issn

1471-2482

pii

10.1186/s12893-020-00694-y

journal_volume

20

pub_type

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