Clinical experience in separation of splenic vessels during laparoscopic distal pancreatectomy with Kimura’s procedure
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R735.9

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    Abstract:

    Objective: To investigate the technical essentials of separation of the splenic vessels in performing Kimura’s procedure (laparoscopic resection of the body and tail of the pancreas with splenic vessel preservation). Methods: The clinical data of 18 patients undergoing resection of the pancreatic body and tail using Kimura’s procedure from January 2015 to December 2016 were retrospectively analyzed. Results: Kimura’s procedure was successfully completed in all the 18 patients. The operative time ranged from 136 to 220 min, with an average of 170 min, and the intraoperative blood loss ranged from 50 to 450 mL, with an average of 180 mL, and the length of hospital stay ranged from 6 to 21 d. with an average of 9.6 d. Postoperative pathology showed that all the lesions were benign or borderline tumors of the pancreas. Ten patints underwent splenic vein or artery repair for lacerations with a 5-0 Prolene suture during operation. Abdominal pancreatic fistula was the main complication, which occurred, including grade A pancreatic fistula in 8 patients (44.4%) and grade B pancreatic fistula in 2 patients(11.1%), and were all cured by conservative treatment. Conclusion: Kimura’s procedure for benign and borderline tumors in the body and tail of the pancreas is safe and feasible, and thorough preoperative preparation, sophisticated laparoscopic techniques and good cooperative abilities, especially the meticulous splenic vessel separating and suturing techniques are essential for completing the operation.

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WU Baoqiang, AN Yong, JIANG Yong, CHEN Xuemin, SUN Donglin. Clinical experience in separation of splenic vessels during laparoscopic distal pancreatectomy with Kimura’s procedure[J]. Chin J Gen Surg,2017,26(9):1162-1167.
DOI:10.3978/j. issn.1005-6947.2017.09.013

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History
  • Received:April 05,2017
  • Revised:August 14,2017
  • Adopted:
  • Online: September 15,2017
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