Laparoscopic Left Pancreatectomy with Splenic Vessel Resection and Spleen Preservation (with Video)

Abstract

The Warshaw technique enables splenic preservation during laparoscopic left pancreatectomy (LLP) for benign and pre-malignant lesions, by sacrificing the splenic vessels in favor of perfusion via the short gastric vessels.

This technical article describes a standardized procedure, with emphasis on exposure using the hanging gastric maneuver and sequential vascular control.

As a viable alternative to splenectomy, it prevents its long-term complications despite a risk of often asymptomatic partial splenic ischemia, thereby expanding the possibilities for conservative surgery in pancreatic oncology.