Robotic Splenic Vessels Preserving Distal Pancreatectomy in a Post-Distal Gastrectomy Patient
Background The optimal procedure during distal pancreatectomy (DP) for patients who have undergone distal gastrectomy (DG) remains unclear. Several papers on remnant gastric ischemia have reported that the preserved splenic vessels are essential for the proximal remnant stomach.1–4 We evaluated the outcomes of DP for post-DG patients in our hospital and introduced robotic splenic vessels preserving DP (R-SPDP). Methods Postoperative short-term outcomes of DP for post-DG patients during 2014 and 2021 were evaluated. Next, R-SPDP was performed for a post-DG patient with the intention of preserving the remnant stomach safely. The double bipolar method was used to dissect the adhesions around the splenic vessels.5,6 The splenic artery was clamped at the root side to prevent bleeding.7 All short gastric arteries and veins, which were the main feeders of the remnant stomach, were preserved and resection was completed. After resection, the indocyanine green (ICG) fluorescence angiography confirmed blood flow in the short gastric arteries and veins and good return blood flow to the splenic vein.8 Results Of four patients (50.0%, of 8 DP patients) in whom the remnant stomach was preserved, one conventional DP case had poor ICG perfusion and presented with remnant stomach ischemia postoperatively. The R-SPDP case with good ICG perfusion had a total operation time of 371 minutes and intraoperative blood loss of 10 mL. The oral diet was started on postoperative Day 3, and the postoperative course was uneventful. Conclusions R-SPDP can be a good option for post-DG patients to preserve the remnant stomach safely..
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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Enthalten in: |
Annals of surgical oncology - 30(2023), 11 vom: 03. Aug., Seite 6680-6681 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Oba, Atsushi [VerfasserIn] |
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Links: |
Volltext [lizenzpflichtig] |
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Themen: |
Bipolar method |
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Anmerkungen: |
© Society of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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doi: |
10.1245/s10434-023-13802-y |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
OLC214559793X |
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520 | |a Background The optimal procedure during distal pancreatectomy (DP) for patients who have undergone distal gastrectomy (DG) remains unclear. Several papers on remnant gastric ischemia have reported that the preserved splenic vessels are essential for the proximal remnant stomach.1–4 We evaluated the outcomes of DP for post-DG patients in our hospital and introduced robotic splenic vessels preserving DP (R-SPDP). Methods Postoperative short-term outcomes of DP for post-DG patients during 2014 and 2021 were evaluated. Next, R-SPDP was performed for a post-DG patient with the intention of preserving the remnant stomach safely. The double bipolar method was used to dissect the adhesions around the splenic vessels.5,6 The splenic artery was clamped at the root side to prevent bleeding.7 All short gastric arteries and veins, which were the main feeders of the remnant stomach, were preserved and resection was completed. After resection, the indocyanine green (ICG) fluorescence angiography confirmed blood flow in the short gastric arteries and veins and good return blood flow to the splenic vein.8 Results Of four patients (50.0%, of 8 DP patients) in whom the remnant stomach was preserved, one conventional DP case had poor ICG perfusion and presented with remnant stomach ischemia postoperatively. The R-SPDP case with good ICG perfusion had a total operation time of 371 minutes and intraoperative blood loss of 10 mL. The oral diet was started on postoperative Day 3, and the postoperative course was uneventful. Conclusions R-SPDP can be a good option for post-DG patients to preserve the remnant stomach safely. | ||
650 | 4 | |a Robotic-assisted pancreatectomy | |
650 | 4 | |a Robotic-assisted surgery | |
650 | 4 | |a Distal gastrectomy | |
650 | 4 | |a Indocyanine green | |
650 | 4 | |a Spleen preserving distal pancreatectomy | |
650 | 4 | |a Bipolar method | |
700 | 1 | |a Maekawa, Aya |4 aut | |
700 | 1 | |a Inoue, Yosuke |4 aut | |
700 | 1 | |a Makuuchi, Rie |4 aut | |
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700 | 1 | |a Sato, Takafumi |4 aut | |
700 | 1 | |a Ohashi, Manabu |4 aut | |
700 | 1 | |a Ito, Hiromichi |4 aut | |
700 | 1 | |a Nunobe, Souya |4 aut | |
700 | 1 | |a Takahashi, Yu |4 aut | |
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