Comparison of Outcomes Between Warshaw and Kimura Techniques for Spleen-preserving Minimally Invasive Distal Pancreatectomy

NCT06084975 | Completed

• 1 other identifier: SP-MIDP
• Study Type: observational
• Target: 314
• Locations: 1 country
• Sites: 1

Brief Summary

Spleen-persevering distal pancreatectomy (SP-DP) has been widely advocated as a routine procedure for benign or low-grade malignant tumors in the pancreatic body and tail, especially with a minimally invasive approach. Spleen preservation can be accomplished with Kimura technique (KT) or Warshaw technique (WT) Both of the two techniques were proved to be feasible and efficient. However, the perioperative outcomes and long-term benefits between patients with KT and WT in spleen-persevering minimally invasive distal pancreatectomy (SP-MIDP) remains controversial. Several small series have reported a slightly higher prevalence of postpancreatectomy hemorrhage (PPH) in patients who undergo KT than those undergo WT. The exposure of splenic vessels to erosive pancreatic juice and the preservation of splenic vessels itself may explain the higher chance of PPH in KT. Larger volume studies are warranted to confirm this finding and to clarify the clinical significance. This study compared the perioperative outcomes between the two spleen-preserving techniques, with a focus on parameters relating to perioperative patient safety. Especially, the incidence and clinical relevance of PPH in SP-MIDP were evaluated.

Conditions

Distal Pancreatectomy; Spleen Preservation; Postpancreatectomy Hemorrhage

Outcome Measures

Primary Outcomes (1)

• major complications

  (Clavien-Dindo grade ≥ III)

  Within 30 days of SP-MIDP

Study Arms (2)

Kimura technique (KT)

Spleen preservation is accomplished by sparing the splenic vessels.

Procedure: Splenic vessels preservation

Warshaw technique (WT)

Spleen preservation is accomplished by sacrificing the splenic vessels and maintaining vascularity through the preserved short gastric and left gastroepiploic vessels.

Interventions

Splenic vessels preservation PROCEDURE

preservation the splenic vessels

Kimura technique (KT)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients who underwent SP-MIDP at our institution between July 2018 and December 2022 were enrolled consecutively.

You may qualify if:

• pathological diagnosis of benign or low-grade malignant pancreas tumors.

You may not qualify if:

• incomplete medical records,
• history of previous splenectomy,
• high-grade malignant pancreas tumors,
• conversion to open DP (ODP).

Sponsors & Collaborators

• Zhejiang University: lead

Study Sites (1)

the First Affiliated Hospital, School of Medicine, Zhejiang University

Hangzhou, Zhejiang, 310003, China

Location

Biospecimen

Retention: SAMPLES WITHOUT DNA

Samples Without DNA

Study Officials

• Liang Tingbo

  Zhejiang University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: October 10, 2023
• First Posted: October 16, 2023
• Study Start: July 1, 2018
• Primary Completion: December 31, 2022
• Study Completion: December 31, 2022
• Last Updated: October 16, 2023

Record last verified: 2023-10

Locations

CN (1)