Analysis of the efficacy of precision minimally invasive technique in laparoscopic spleen-preserving distal pancreatectomy
HUANG Xin
LI Xiaodong
GU Haowu
NAN Bo
TIE Jingjing
ZHANG Ning
WANG Zhenhua
WU Feifei
WANG Yayun
LI Xiaoyong
YANG Yanling
Abstract：Objective To comparatively study the clinical efficacy and safety between Kimura and Warshaw procedures in laparoscopic spleen-preserving distal pancreatectomy(LSPDP).Methods A retrospective cohort study design was conducted,involving 102 patients who underwent LSPDP from June 2018 to June 2023,with 62 cases in the Kimura group and 40 cases in the Warshaw group.Perioperative indicators,splenic function preservation,and complications were compared between the two groups.Results The Warshaw group exhibited significantly higher incidence of splenic infarction than the Kimura group(22.5％vs 3.2％,P=0.003),with 3 cases of overwhelming post-splenectomy infection observed.Tuftsin levels at 6 months postoperatively were higher in the Kimura group[(0.82±0.11)mg/L vs(0.71±0.13)mg/L,P=0.002)].The Kimura group demonstrated shorter operative time[(185.6±35.2)min vs(215.4±42.1)min,P=0.012)]and reduced blood loss[(152.8±89.5)mL vs(298.6±120.7)mL,P＜0.001)].Multivariate analysis identified type Ⅳ splenic vessels(OR=6.63)and intraoperative blood loss＞300 mL(OR=4.77)as independent risk factors for spleen preservation failure.Conclusion The Kimura procedure demonstrates advantages in reducing splenic infarction risk,preserving immune function,and enhancing surgical safety through maintenance of splenic hilar vascular integrity,providing practical evidence for"Functional Spleen Preservation".
Keywords：laparoscopicpancreatectomyKimura's methodWarshaw's methodperioperative complicationssplenic infarctionsplenic hilar vascularoverwhelming post-splenectomy infection
Publication Date：2025-09-30
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 1163-1169 )