Robotic distal pancreatectomy: Comparison of spleen-preservation by the Warshaw technique and splenectomy

BackgroundOutcomes after robotic distal pancreatectomy with spleen preservation (RDP-SP) by the Warshaw technique and with splenectomy (RDP-S) were compared. MethodsAll the data for patients undergoing robotic distal pancreatectomy (RDP) were prospectively collected. ResultsA total of 66 patients were included, with 33 in each group. The console time was significantly shorter in the RDP-SP group than in the RDP-S group (165minutes vs. 220minutes). The median blood loss was 50cm(3) in the RDP-SP group and 100cm(3) in the RDP-S group. The surgical morbidity was significantly lower in RDP-SP group (18% vs. 58%). Spleen infarction (15%), gastric varices (6%) and perigastric varices (45%) after RDP-SP were not associated with any subsequent complication. Postoperative platelet count and white blood cell (WBC) count were significantly higher in the RDP-S group. ConclusionsBoth RDP-SP and RDP-S are feasible in selected patients. RDP-SP is feasible and time-saving. Although gastric/perigastric varices and spleen infarction are not uncommon after RDP-SP, they appear to be clinically irrelevant.