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Comparison of splenic vessel preserving distal pancreatectomy and the Warshaw technique for solid pseudopapillary neoplasm in children

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Funding

This study was supported by a grant (2016-1268) from Asan Medical Center Children’s Hospital, Seoul, Korea.

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Authors and Affiliations

  1. 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

    Yong Jae Kwon, Dae Yeon Kim, Seong Chul Kim, Hyunhee Kwon & Jung-Man Namgoong

  2. Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Song Cheol Kim

  3. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jae Moon Choi

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  1. Yong Jae Kwon
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  2. Dae Yeon Kim
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  4. Song Cheol Kim
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  5. Hyunhee Kwon
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Correspondence to Jung-Man Namgoong.

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Kwon, Y.J., Kim, D.Y., Kim, S.C. et al. Comparison of splenic vessel preserving distal pancreatectomy and the Warshaw technique for solid pseudopapillary neoplasm in children. Pediatr Surg Int 38, 1143–1148 (2022). https://doi.org/10.1007/s00383-022-05134-x

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