Why is important to know how spleen survives after spleen-preserving distal pancreatectomy with splenic vessels resection? experience of 51 operations without splenectomies

Background: Knowledge of spleen collaterals is important as for distal spleen-preserving pancreatectomy with splenic vessels resection (DSPPSVR), so possible upper GI surgery these patients. Objective: Primary: To clarify the sources blood supply after DSPPSVR. Secondary: morbidity and mortality Methods: Retrospective analysis case histories CT angiograms (CТА) before DSPPSVR (n51). Results: Indications surgery: MCN (37), bd-IPMN (7), CSA(3), NEN(4). Open(41) laparoscopic (10) were used. No mortality, - 15(29%), fistula Grade B 4 (8%), Spleen infarctions- 7 (14%), clinically significant infarctions splenectomies- 0. CTA revealed three types DSPPSVR: gastro-epiploic arcade (GEA) a main collateral artery (n8, 16%), short gastric arteries (SGA) (n6, 12%) intermediate type (n36, 72%). Conclusion: In SPDP SVR in 1/3 cases only GEA or SGA are collaterals, supplying spleen, 2/3 both ways involved. mandatory abdominal patients SVR.