Application of the pancreatic body suspension technique in laparoscopic splenectomy combined with selective pericardial varicosity dissection: An observational study

Abstract

To investigate the safety of pancreatic body suspension (PBS) technique in laparoscopic splenectomy combined with pericardial devascularization for patients. A retrospective study inclusive of 16 patients who underwent laparoscopic splenectomy combined with pericardial devascularization from 2017 to 2022 was performed. A total of 5 patients underwent PBS technique and 11 underwent the traditional technique. There was no significant difference in age, sex, body mass index (BMI), preoperative serum white cell count (WBC), platelets (PLT), hemoglobin (HB), albumin (ALB), prothrombin time (PT), total bilirubin (TBIL), or spleen size between the 2 groups (P > .05). In the PBS group, the operation time was 280 minutes. The estimated intraoperative blood loss (EBL) was 250 mL. The mean postoperative hospitalization length was 11.2 days. There was no conversion to an open procedure or postoperative bleeding. In the traditional method group, the mean operation time was 240.91 minutes. The EBL was 290.91 mL. There were 2 cases of conversion to open, 3 cases of postoperative bleeding, and 1 reoperation. The incidence of postoperative short-term complications (postoperative bleeding, reoperation) was significantly higher in the traditional method group than in the PBS group (36.36% vs 0%, P = .034). PBS technique improved the safety of laparoscopic splenectomy combined with pericardial dissection and is worthy of clinical promotion.

Figure 1.

(A) The laparoscopic trocar layout. The 5-hole method with the camera port placed infraumbilically is shown. (B) Dissecting the inferior pole of the spleen. (C) Dissecting the splenic vascular triangle (indicated by the arrow). (D) Establishment of a tunnel behind the pancreatic body to connect with the splenic vascular triangle. (E) The pancreatic body was suspended and pulled caudally exposing the vessels in the upper pole of the spleen for dissection and separation. (F) The splenic portal vessel was divided using a cutting and closure device. (G) Seven cm of “bare” esophagus from the cardiac peripheral blood vessels.