Distal pancreatectomy without splenectomy and with preservation of splenicvessels

Background/Aims: Conventional distal pancreatic resection routinely involve s splenectomy. The awareness that spleen removal may lead to postoperative septic and hematological complications motivated the development of spleen- preserving procedures. Successful distal pancreatectomy with splenic conser vation has been reported for treatment of benign pancreatic diseases of the distal pancreas. This report presents the results of spleen-preserving dis tal pancreatectomy with conservation of the splenic artery and vein. Methodology: Ten patients underwent distal pancreatectomy with splenic vess el preservation. In all cases, both splenic vessels were separated hom the pancreas towards the spleen after transecting the body of the pancreas. Results: The indications for the procedure were: neuroendocrine pancreatic tumors (n = 4), cystic neoplasm of the pancreas (n = 4) and cystic-papillar y pancreatic tumors (n = 2). Four patients developed pancreatic fistulas wi th spontaneous healing and there was no mortality. Conclusions: Spleen-preserving distal pancreatectomy with splenic vessel co nservation can be safely performed and should be indicated in the surgical management of benign pancreatic diseases-of the distal pancreas.