Print Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Lau D, Chan A. Lau D, & Chan A Lau, Davy, and Alex Chan. Combined division of the splenic vein a safe method for distal pancreatectomy. 2 Minute Medicine, 11 March 2021. McGraw-Hill, 2021. AccessSurgery. https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=555782§ionid=254586037APA Citation Lau D, Chan A. Lau D, & Chan A Lau, Davy, and Alex Chan. (2021). Combined division of the splenic vein a safe method for distal pancreatectomy. (2021). 2 minute medicine. McGraw-Hill. https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=555782§ionid=254586037.MLA Citation Lau D, Chan A. Lau D, & Chan A Lau, Davy, and Alex Chan. "Combined division of the splenic vein a safe method for distal pancreatectomy." 2 Minute Medicine McGraw-Hill, 2021, https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=555782§ionid=254586037. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Combined division of the splenic vein a safe method for distal pancreatectomy by Davy Lau, Alex Chan Listen +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. +Safety of combined division vs separate division of the splenic vein in patients undergoing distal pancreatectomy +1. In distal pancreatectomy procedures, combined division of the splenic vein with the pancreatic parenchyma had no difference in safety compared to the conventional, separated division method. +Evidence Rating Level: 1 (Excellent) +In a distal pancreatectomy (DP) procedure, apart from dissecting the pancreas, surgeons conventionally dissect the splenic artery and vein after isolating them from the pancreas parenchyma. The logic of this isolation was to prevent potential pancreatic fistulas (PFs) and intra-abdominal hemorrhage, which is reported in 1-8% of DP patients. However, a simpler method is dissecting the splenic vein and pancreatic parenchyma together, although the safety of this technique has not previously been investigated. Therefore, the aim of this multicentre, phase 3 randomized controlled trial, was to establish the non-inferiority of the combined resection versus separated resection of the splenic vein in DP procedures. There were 316 patients overall (159 in the intent-to-treat separate division, 157 in the intent-to-treat combined division), with procedures done in 45 institutions in Japan between 2016 and 2019. The primary outcome measured was the incidence of grade B/C PF. In the separate division group, the incidence was 27.1% (42 patients), compared to 28.6% (44 patients) in the combined division (odds ratio 1.108, 95% CI 0.847-1.225, p = 0.047). Additionally, there were no differences in operative time, blood loss, or incidence of postoperative intra-abdominal hemorrhage (only 2 patients in each group experienced this). Although there was a higher incidence of pancreatic injury, such as laceration, in the combined group, the difference was not statistically significant (5.9% versus 2.0%, p = 0.14). Overall, the study demonstrated non-inferiority of the technique involving dissection of the pancreatic parenchyma combined with the splenic vein, compared to the technique involving separate dissection, for distal pancreatectomy procedures. +©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.