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

Vervekin I.V.; Trushin A.A.; Kursenko R.V.; Gainullina L.I.; Zakharenko A.A.

doi:https://doi.org/10.17116/hirurgia202501122

Vervekin I.V.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0002-3036-9779

Trushin A.A.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0003-3316-9956

Kursenko R.V.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0002-0224-8697

Gainullina L.I.

Pavlov First St. Petersburg State Medical University

ORCID: 0009-0009-6084-5017

Zakharenko A.A.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0002-8514-5377

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

Authors:

Vervekin I.V., Trushin A.A., Kursenko R.V., Gainullina L.I., Zakharenko A.A.

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Journal: Pirogov Russian Journal of Surgery. 2025;(1): 22‑28

DOI: 10.17116/hirurgia202501122

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To cite this article:

Vervekin IV, Trushin AA, Kursenko RV, Gainullina LI, Zakharenko AA. Immediate results of laparoscopic spleen-preserving distal pancreatectomy: Kimura vs Warshaw procedure. Pirogov Russian Journal of Surgery. 2025;(1):22‑28. (In Russ.)
https://doi.org/10.17116/hirurgia202501122

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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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.

Keywords:

benign pancreatic tumor

corpocaudal pancreatectomy

distal pancreatectomy

laparoscopy

pancreatic surgery

Authors:

Vervekin I.V.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0002-3036-9779

Trushin A.A.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0003-3316-9956

Kursenko R.V.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0002-0224-8697

Gainullina L.I.

Pavlov First St. Petersburg State Medical University

ORCID: 0009-0009-6084-5017

Zakharenko A.A.

Pavlov First St. Petersburg State Medical University

ORCID: 0000-0002-8514-5377

Received:

18.03.2024

Accepted:

11.04.2024

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