Abstract
Aim
Isolating the root of the splenic artery (SPA) is a challenging procedure in laparoscopic distal pancreatectomy (LDP). We investigated the usefulness of evaluation of the relationship between the SPA and pancreatic parenchyma using three-dimensional computed tomography (3D-CT).
Methods
In total, 104 patients were evaluated. The relationship between the SPA and pancreatic parenchyma was classified into two types: buried and non-buried. Video clips of 50 patients who underwent LDP requiring isolation of the SPA root were reviewed to determine whether the classification is related to difficulty of LDP.
Results
Of the 50 assessed patients who underwent LDP, the relationship between the SPA and pancreatic parenchyma was the buried type in 30 (60.0%) and non-buried type in 20 (40.0%). The buried type was associated with a significantly longer median operative time than the non-buried type (285.0 vs. 235.5 min, respectively; P < 0.01). The median time required to isolate the SPA in the buried type (25.8 min; range, 4.0–101 min) was significantly longer than that in the non-buried type (7.0 min; range, 1.0–27.0 min) (P < 0.001).
Conclusion
Preoperative 3D-CT around the pancreas is practical for predicting the difficulty of SPA isolation and determining the safety of the procedure.
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Acknowledgments
We thank Angela Morben, DVM, ELS, and Hugh McGonigle, from Edanz Group (https://en-author-services.edanz.com/ac), for editing drafts of this manuscript.
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All authors (Drs. Kohei Nakata, Takao Ohtsuka, Yoshihiro Miyasaka, Yusuke Watanabe, Yasuhisa Mori, Naoki Ikenaga, and Masafumi Nakamura) have no conflicts of interest or financial ties to disclose.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study does not include animals. The Institutional Review Board of Kyushu University Hospital approved this study’s protocol (approved number 2019-089). The need for consent in this study is waived by our review board.
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Nakata, K., Ohtsuka, T., Miyasaka, Y. et al. Evaluation of relationship between splenic artery and pancreatic parenchyma using three-dimensional computed tomography for laparoscopic distal pancreatectomy. Langenbecks Arch Surg 406, 1885–1892 (2021). https://doi.org/10.1007/s00423-021-02101-3
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DOI: https://doi.org/10.1007/s00423-021-02101-3