Ebrahim Eyad, Chae Hochang, Kim Hyeong Seok, Yoon So Jeong, Shin Sang Hyun, Han In Woong, Heo Jin Seok, Kim Hongbeom
Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
King Faisal Hospital, Makkah, Saudi Arabia.
J Hepatobiliary Pancreat Sci. 2025 Sep 17. doi: 10.1002/jhbp.70009.
The Warshaw technique for spleen-preserving distal pancreatectomy (SPDP), which sacrifices splenic vessels, is widely used for benign and borderline malignant pancreatic diseases due to its technical simplicity. However, it carries the risk of splenic infarction. This study aimed to evaluate the incidence, risk factors, and clinical course of splenic infarction in patients who underwent SPDP using the Warshaw technique.
Patients who underwent SPDP using the Warshaw technique at the Samsung Medical Center between 2007 and 2022 were retrospectively analyzed. Postoperative computed tomography scans were reviewed by a single researcher to classify splenic infarction severity based on the extent of infarction.
About 158 patients underwent the Warshaw technique. Splenic infarction was observed in 75 patients (47.5%). Among these, 34 cases (21.5%) were classified as severe (> 50%) infarction. Univariate and multivariate analysis identified previous abdominal surgery as the only statistically significant risk factor. Among the 75 patients with splenic infarction, two required antibiotic management, while none required radiological intervention.
Splenic infarction after SPDP using the Warshaw technique was clinically insignificant. These findings support the use of the Warshaw technique as a feasible and effective option for treating benign and borderline malignant pancreatic diseases.
用于保留脾脏的远端胰腺切除术（SPDP）的华沙技术，即牺牲脾血管，因其技术简单而广泛应用于良性和交界性恶性胰腺疾病。然而，它存在脾梗死的风险。本研究旨在评估采用华沙技术行SPDP患者脾梗死的发生率、危险因素及临床病程。
回顾性分析2007年至2022年在三星医疗中心采用华沙技术行SPDP的患者。由一名研究人员复查术后计算机断层扫描，根据梗死范围对脾梗死严重程度进行分类。
约158例患者接受了华沙技术手术。75例（47.5%）患者出现脾梗死。其中，34例（21.5%）被分类为严重（>50%）梗死。单因素和多因素分析确定既往腹部手术是唯一具有统计学意义的危险因素。在75例脾梗死患者中，2例需要抗生素治疗，无一例需要放射介入治疗。
采用华沙技术行SPDP术后的脾梗死在临床上无显著意义。这些发现支持将华沙技术作为治疗良性和交界性恶性胰腺疾病的一种可行且有效的选择。
