Long-term outcomes following spleen-preserving distal pancreatectomy demonstrate that both the Warshaw (splenic vessel resection) and Kimura (splenic vessel preservation) techniques are safe and effective when appropriately selected. In a bi-institutional cohort of 297 patients , the Warshaw approach was more frequently used for l arger, proximal, and malignant or technically complex lesions , whereas the Kimura technique was more often performed using minimally invasive surgery and was associated with shorter operative times. Short-term morbidity, readmission, and mortality were comparable between techniques.
During a median follow-up of nearly 7 years , splenic hypoperfusion and perigastric varices occurred more frequently after the Warshaw procedure, though these findings were largely clinically silent and rarely necessitated secondary splenectomy. Overall, an anatomy- and…
