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Related Experiment Video

Updated: May 27, 2026

Treatment of Middle-segment Pancreatic Benign Tumor Using Laparoscopic Central Pancreatectomy with End-to-end Pancreatic Duct Reconstruction
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Treatment of Middle-segment Pancreatic Benign Tumor Using Laparoscopic Central Pancreatectomy with End-to-end Pancreatic Duct Reconstruction

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Distal pancreatectomy (with video).

Shinichi Egawa1, Takaho Okada, Fuyuhiko Motoi

  • 1Division of Hepato-Biliary-Pancreatic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo Aoba, Sendai, 980-8574, Japan. egawas@surg1.med.tohoku.ac.jp

Journal of Hepato-Biliary-Pancreatic Sciences
|November 15, 2011
PubMed
Summary

Distal pancreatectomy, a surgery for pancreatic body and tail lesions, can be performed preserving the spleen using techniques like the Warshaw or Kimura procedures. Careful surgical technique minimizes complications and pancreatic fistula risk.

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Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery
  • Pancreatic Surgery

Background:

  • Distal pancreatectomy is essential for treating pancreatic body and tail lesions.
  • Laparoscopic approaches necessitate a thorough understanding of pancreatic anatomy.
  • Spleen-preserving distal pancreatectomy is indicated for localized pancreatic lesions.

Purpose of the Study:

  • To present a standard medial approach for distal pancreatectomy.
  • To highlight techniques for spleen preservation during distal pancreatectomy.
  • To discuss methods for minimizing intraoperative and postoperative complications.

Main Methods:

  • Video demonstration of a standard medial approach for distal pancreatectomy.
  • Discussion of spleen-preserving techniques: Warshaw (short gastric vessels) and Kimura (splenic vessels).

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  • Emphasis on careful anatomical identification and vessel management during surgery.

    • Main Results:

    • Intraoperative complications can be reduced by avoiding splenic capsule injury and accurately differentiating arteries.
    • Secure closure of the splenic vein stump is crucial.
    • Postoperative pancreatic fistula incidence is reported at 13% in a national registry.

    Conclusions:

    • Spleen-preserving distal pancreatectomy can be achieved through various techniques, including laparoscopic approaches.
    • Minimizing intraoperative injury and ensuring secure vascular closure are key to reducing complications.
    • The choice of pancreatic stump closure method (hand-sewn vs. staple) is at the surgeon's discretion.