Division of Pediatric Surgery, Department of Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Pediatr Surg Int. 2022 Aug;38(8):1143-1148. doi: 10.1007/s00383-022-05134-x. Epub 2022 May 28.
Spleen-preserving distal pancreatectomy (SPDP) such as splenic vessel preservation (SVP) for solid pseudopapillary neoplasms (SPNs) in the body or tail of the pancreas in children prevents post-splenectomy infection and hematologic disorders. However, SVP could be technically challenging, and the Warshaw technique (WT) could be an alternative technique that has been reported to be safe and effective in adults. We, therefore, compared the perioperative outcomes of SVP and WT in pediatric patients.
We retrospectively reviewed the medical records of pediatric patients with SPN who underwent SPDP using SVP or WT between November 2002 and November 2018 at a large-sized tertiary referral center.
Twenty-eight patients were included. Sixteen (57.1%) patients underwent SVP and 12 (42.9%) patients underwent WT. There were no significant differences in the baseline characteristics between the two groups. Postoperative complications occurred in 8 patients each in the SVP (50%), and the WT (66.7%) groups. Two (12.5%) in the SVP group and 1 (8.3%) in the WT group required additional intervention. During a median follow-up duration of 49 months, there were no significant differences in the incidence of splenic infarctions or perigastric varices between the two groups.
There were no significant differences in the surgical outcomes between WT and SVP in pediatric patients with SPN. WT could be a safe and feasible alternative technique for SVP in challenging cases.
保脾胰体尾切除术（SPDP），如儿童胰腺体尾部实性假乳头状瘤（SPN）中的脾血管保留（SVP），可预防脾切除术后感染和血液系统疾病。然而，SVP 可能具有技术挑战性，而 Warshaw 技术（WT）可能是一种替代技术，在成人中已被报道为安全有效的方法。因此，我们比较了 SVP 和 WT 在儿科患者中的围手术期结果。
我们回顾性分析了 2002 年 11 月至 2018 年 11 月在一家大型三级转诊中心接受 SPDP 的 SPN 患儿采用 SVP 或 WT 的病历。
共纳入 28 例患者。16 例（57.1%）患者行 SVP，12 例（42.9%）患者行 WT。两组患者的基线特征无显著差异。SV 组（50%）和 WT 组（66.7%）各有 8 例患者发生术后并发症。SV 组中有 2 例（12.5%）和 WT 组中有 1 例（8.3%）需要额外干预。在中位数为 49 个月的随访期间，两组患者的脾梗死或胃周静脉曲张发生率无显著差异。
在 SPN 儿童中，WT 与 SVP 的手术结果无显著差异。在有挑战性的情况下，WT 可能是 SVP 的一种安全可行的替代技术。
