[Immediate results of laparoscopic spleen-preserving distal pancreatectomy: Kimura vs Warshaw procedure].

Abstract

Objective: To study the immediate results of spleen-preserving distal pancreatectomy and to compare the outcomes after Kimura and Warshaw procedures.

Material and methods: A retrospective non-randomized study included 27 patients with benign tumors of pancreatic tail and body who underwent spleen preserving distal pancreatectomy between 2020 and 2024. All patients were divided into 2 groups: 1 - Kimura procedure (n=16), 2 - Warshaw procedure (n=16). We excluded patients who underwent enucleations, central resections, and other interventions instead of distal pancreatectomy.

Results: Mean surgery time was 269.06±70.95 (95% CI 227.74 - 319. 95) and 197.27±42.09 min (95% CI 184.36 - 240.64), respectively (p=0.006). Blood loss, length of hospital day, incidence of laparotomy, splenectomy, splenic infarction, and redo surgeries were similar. Clinically significant postoperative fistula B-C was more common in 1^st group (10 (62.4%) vs. 5 (45.5%) cases, p=0.028). There were no significant between-group differences in the incidence of postoperative complications Clavien-Dindo grade >III and mortality.

Conclusion: Laparoscopic spleen preserving distal pancreatectomy is the «gold» standard for benign tumors of pancreatic body and tail. The Warshaw and Kimura techniques are safe and effective surgical approaches with similar results. The Warshaw procedure may be more advantageous regarding less surgical resources without deterioration of immediate postoperative results.