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

Int J Med Robot. 2018 Oct;14(5):e1922. doi: 10.1002/rcs.1922. Epub 2018 May 10.

Abstract

Background: Outcomes after robotic distal pancreatectomy with spleen preservation (RDP-SP) by the Warshaw technique and with splenectomy (RDP-S) were compared.

Methods: All the data for patients undergoing robotic distal pancreatectomy (RDP) were prospectively collected.

Results: A total of 66 patients were included, with 33 in each group. The console time was significantly shorter in the RDP-SP group than in the RDP-S group (165 minutes vs. 220 minutes). The median blood loss was 50 cm3 in the RDP-SP group and 100 cm3 in the RDP-S group. The surgical morbidity was significantly lower in RDP-SP group (18% vs. 58%). Spleen infarction (15%), gastric varices (6%) and perigastric varices (45%) after RDP-SP were not associated with any subsequent complication. Postoperative platelet count and white blood cell (WBC) count were significantly higher in the RDP-S group.

Conclusions: Both RDP-SP and RDP-S are feasible in selected patients. RDP-SP is feasible and time-saving. Although gastric/perigastric varices and spleen infarction are not uncommon after RDP-SP, they appear to be clinically irrelevant.

Keywords: Warshaw technique; distal pancreatectomy; robotic; splenectomy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Platelet Count
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Splenectomy / methods*