Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) versus Open Spleen-Preserving Distal Pancreatectomy (OSPDP): A Comparative Study
Figure 2
(a) Stomach is hanged superiorly and anteriorly from the abdominal wall. (b) Identification of the splenic artery and placement of the vascular loop around the splenic artery to provide counter traction. (c) Dissection of the inferior-posterior margin of the pancreas to expose superior mesenteric vein (SMV), inferior mesenteric vein (IMV), and the splenic vein. (d) The neck of pancreas is divided with a endoscopic stapler. (e) Dissection of the dorsal side of the pancreas, pulling of the distal pancreatic stump with body and tail to the left lateral side in order to free the splenic vessels from the distal pancreas. (f) Preservation of the splenic vein and artery (the body and tail of the pancreas are removed). SV: splenic vein, SA: splenic artery, and SMV: superior mesenteric vein.