Distal pancreatectomy: en‐bloc splenectomy vs spleen‐preserving pancreatectomy

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Abstract
In general, distal pancreatectomy is performed en‐bloc along with resection of the spleen. Most of the time, the en‐bloc pancreatic‐spleen resection is performed for technical reasons; it makes the operation short and easy but does not offer any special advantage for the patient. Overwhelming sepsis after distal pancreatectomy and splenectomy has been reported 1 x [1] Holdsworth, R.J., Irving, A.D., and Cuschieri, A. Postsplenectomy sepsis and its mortality rate: actual versus perceived. Br J Surg. 1991; 78: 1031–1038 Crossref | PubMed | Scopus (360) | Google Scholar See all References 1 . Kimura et al. 2 x [2] Kimura, W., Inoue, T., Futakawa, N., Shinkai, H., and Muto, T. Spleen‐preserving distal pancreatectomy with conservation of the splenic artery and vein. Surgery. 1996; 120: 885–890 Abstract | Full Text PDF | PubMed | Scopus (142) | Google Scholar See all References 2 , have described the technique of preserving both the splenic artery and vein. In addition, Warshaw 3 x [3] Warshaw, A.L. Conservation of the spleen with distal pancreatectomy. Arch Surg. 1988; 123: 550–553 Crossref | PubMed | Scopus (360) | Google Scholar See all References 3 has described a technique of distal pancreatectomy in which splenic vessels are ligated both at the level of transection of the pancreas and again at the splenic hilum, leaving the spleen to survive on blood flow through the short gastric vessels. Others have described techniques whereby the pancreas is dissected off the splenic vessels completely 4 x [4] Aldridge, M.C. and Williamson, R.C.N. Distal pancreatectomy with and without splenectomy. Br J Surg. 1991; 78: 976–979 Crossref | PubMed | Scopus (131) | Google Scholar See all References 4 .