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Query: UMLS:C0153470 (Spleen)
 4,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preservation of the spleen at distal pancreatectomy has recently attracted considerable attention. Since our first trial and success with spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for tumors of the pancreas and chronic pancreatitis, this procedure has been performed more frequently. Three patients with intraductal papillary-mucinous tumor underwent spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. In this procedure, the splenic vein is identified behind the pancreas and the connective tissue membrane is cut longitudinally above the splenic vein. An important point is to remove the splenic vein from the pancreas from the body of the pancreas toward the spleen. In one patient with intraductal papillary-mucinous tumor in the body of the pancreas who had undergone distal gastrectomy for duodenal ulcer 32 years previously, residual proximal gastrectomy could be avoided with this procedure. In this case, the histological diagnosis was a pseudocyst, and epithelial dysplasia was found in other pancreatic ductuli. In another case, epithelia were borderline between hyperplasia and adenoma. In both of these cases, the histological diagnosis was different from the preoperative diagnosis. Even with advances in imaging techniques, diagnosis of a cystic lesion of the pancreas is still very difficult. Ordinary distal pancreatectomy with splenectomy would have been oversurgery in these two cases, which could be avoided using our procedure. Severe complications were not found in any of the three cases and the postoperative course was uneventful. The patients have been followed as outpatients without any recurrence. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein is easy and safe, and should be performed for some patients with intraductal papillary mucinous tumor of the pancreas.
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PMID:Spleen-preserving distal pancreatectomy with preservation of the splenic artery and vein for intraductal papillary-mucinous tumor (IPMT): three interesting cases. 1469 8

Distal pancreatectomy with en-bloc splenectomy has been considered the standard technique for management of benign and malignant pancreatic disorders. However, splenic preservation has recently been advocated. The aim of this study was to review the experiences of distal pancreatectomy using the open or the laparoscopic approach and to critically discuss the need to perform splenectomy. Original articles published in the English literature of peer-reviewed medical journals were selected for detailed analysis. In patients with malignant neoplasms in the body-tail of the pancreas, splenectomy has a negative influence on long-term survival after resection. The incidence of diabetes after spleen-preserving distal pancreatectomy for chronic pancreatitis is less than after en-bloc splenectomy. Spleen salvage eliminates the risk of overwhelming infections. Laparoscopic spleen-preserving distal pancreatectomy is feasible and safe. Laparoscopic spleen-preserving distal pancreatectomy may be preferable for the advantages of a minimally invasive approach.
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PMID:Distal pancreatectomy: en-bloc splenectomy vs spleen-preserving pancreatectomy. 1833 70

During recent years, spleen-preserving distal pancreatectomy (SPDP) has broadened the operative spectrum in pancreatic surgery. The rationale for spleen-preserving procedures comprises prevention of overwhelming postsplenectomy infection syndrome (OPSI) and possibly an advantage regarding reduced carcinogenesis. Although there are no prospective randomized trials, SPDP and distal pancreatectomy with splenectomy (DPSx) seem to be equivalent in terms of blood loss, operative time, mortality and frequency of reoperation. Concerning pancreatic fistulas and other major surgical complications, current data from the literature are conflicting. Long-term effects of SPDP, such as development of gastric varices due to portal hypertension, are still insufficiently investigated. However, SPDP should always be considered in patients with benign tumors of the pancreatic tail and chronic pancreatitis. Spleen-preserving distal pancreatectomy can also be combined with resection of the splenic vessels (DPSx-SVx) if the blood supply of the spleen via the small gastric vessels and the gastro-epoploic arcade is sufficient. In the presence of malignant tumors, DPSx is necessary for oncological reasons.
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PMID:[Distal pancreatectomy: radical or spleen-preserving?]. 1882 53

Few things in radiology are "pathognomonic" in their appearance or presentation. However, having an awareness of those findings which are specific to a certain entity is important when interpreting imaging studies. These classic findings can be identified with many imaging modalities, but no modality provides as many recognizable observations as an MRI. This results from the large variety of pulse sequences that provide high contrast resolution, prior to and following contrast administration. In this article, the most classically recognized abdominal findings are presented including the following: Liver: Cyst, hemangioma, focal nodular hyperplasia, hepatic adenoma, hemosiderosis, hepatocellular carcinoma. Spleen: Cyst, hemangioma, lymphangioma, hemosiderosis, Gandy-Gamna bodies. Biliary system: Biliary stones and choledocholithiasis, pneumobilia, choledochal cyst. Gallbladder: Adenomyomatosis, sludge, surgical clips in the gallbladder fossa. Pancreas: Pancreatic divisum, intraductal papillary mucinous neoplasm, pseudocyst, autoimmune pancreatitis, chronic pancreatitis, adenocarcinoma. Kidneys: Simple cyst, hemorrhagic cyst, renal sinus cyst, angiomyolipoma, solid mass.
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PMID:Interpreting body MRI cases: classic findings in abdominal MRI. 2959 65