PDF(Pubmed)
Abstract：
UNASSIGNED: The Warshaw method as a technique for spleen-preserving distal pancreatectomy (SPDP) carries the risk of splenic infarction following splenic artery ligation. This study introduces a modified Warshaw method, which preserves the splenic artery while sacrificing the splenic vein, and compares its outcomes with the traditional Warshaw method.
UNASSIGNED: According to the bleeding status during vessel dissection, either the Warshaw method (group W) or the modified Warshaw method (group MW) was used. Guided by preoperative imaging, we utilized the planned modified Warshaw method (group PMW) when the splenic vein was embedded in the pancreatic parenchyma.
UNASSIGNED: Group MW demonstrated a lower incidence of splenic infarction and engorged gastric collaterals than group W (6.3% vs. 69.8%, P<0.001; 25.0% vs. 55.8%, P=0.003, respectively). There were no significant differences in perioperative changes of splenic volume between the two groups. Group PMW experienced less estimated blood loss than group W (71.9±59.13 vs. 357.9±447.72 cc, P=0.006).
UNASSIGNED: The planned modified Warshaw method is an efficient and safe technique, resulting in lower estimated blood loss and favorable outcomes concerning splenic infarction and gastric collaterals than the Warshaw method without inducing congestive splenomegaly.
UNASSIGNED: According to the bleeding status during vessel dissection, either the Warshaw method (group W) or the modified Warshaw method (group MW) was used. Guided by preoperative imaging, we utilized the planned modified Warshaw method (group PMW) when the splenic vein was embedded in the pancreatic parenchyma.
UNASSIGNED: Group MW demonstrated a lower incidence of splenic infarction and engorged gastric collaterals than group W (6.3% vs. 69.8%, P<0.001; 25.0% vs. 55.8%, P=0.003, respectively). There were no significant differences in perioperative changes of splenic volume between the two groups. Group PMW experienced less estimated blood loss than group W (71.9±59.13 vs. 357.9±447.72 cc, P=0.006).
UNASSIGNED: The planned modified Warshaw method is an efficient and safe technique, resulting in lower estimated blood loss and favorable outcomes concerning splenic infarction and gastric collaterals than the Warshaw method without inducing congestive splenomegaly.
摘要：
■Warshaw方法作为保留脾脏的远端胰腺切除术（SPDP）的技术，在脾动脉结扎后存在脾梗塞的风险。这项研究介绍了一种改进的Warshaw方法，保留脾动脉，同时牺牲脾静脉，并将其结果与传统的Warshaw方法进行比较。
■根据血管解剖过程中的出血状况，使用Warshaw方法(W组)或改良的Warshaw方法(MW组)。在术前影像学引导下,当脾静脉嵌入胰腺实质时，我们使用了计划的改良Warshaw方法（PMW组）。
■MW组的脾梗死和胃络充血的发生率低于W组（6.3％vs.69.8%,P<0.001;25.0%vs.55.8%,分别为P=0.003)。两组患者围手术期脾体积变化差异无统计学意义。PMW组的估计失血量少于W组（71.9±59.13vs.357.9±447.72cc,P=0.006)。
■计划的修改后的Warshaw方法是一种高效且安全的技术，与Warshaw方法相比，在不引起充血性脾肿大的情况下，估计的失血量较低，脾梗死和胃络的预后良好。
■根据血管解剖过程中的出血状况，使用Warshaw方法(W组)或改良的Warshaw方法(MW组)。在术前影像学引导下,当脾静脉嵌入胰腺实质时，我们使用了计划的改良Warshaw方法（PMW组）。
■MW组的脾梗死和胃络充血的发生率低于W组（6.3％vs.69.8%,P<0.001;25.0%vs.55.8%,分别为P=0.003)。两组患者围手术期脾体积变化差异无统计学意义。PMW组的估计失血量少于W组（71.9±59.13vs.357.9±447.72cc,P=0.006)。
■计划的修改后的Warshaw方法是一种高效且安全的技术，与Warshaw方法相比，在不引起充血性脾肿大的情况下，估计的失血量较低，脾梗死和胃络的预后良好。
