Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study
Abstract Background Minimally invasive left pancreatectomy (MILP) is increasingly performed worldwide, necessitating the need for improved understanding of vascular anatomy during surgery. However, the effect of differences in vascular anatomy on surgical outcomes remains unclear. In this study, we...
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BMC
2025-02-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03700-w |
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| author | Masahiro Fukada Noriki Mitsui Takeshi Horaguchi Yuji Hatanaka Itaru Yasufuku Yuta Sato Jesse Yu Tajima Shigeru Kiyama Yoshihiro Tanaka Katsutoshi Murase Nobuhisa Matsuhashi |
| author_facet | Masahiro Fukada Noriki Mitsui Takeshi Horaguchi Yuji Hatanaka Itaru Yasufuku Yuta Sato Jesse Yu Tajima Shigeru Kiyama Yoshihiro Tanaka Katsutoshi Murase Nobuhisa Matsuhashi |
| author_sort | Masahiro Fukada |
| collection | DOAJ |
| description | Abstract Background Minimally invasive left pancreatectomy (MILP) is increasingly performed worldwide, necessitating the need for improved understanding of vascular anatomy during surgery. However, the effect of differences in vascular anatomy on surgical outcomes remains unclear. In this study, we aimed to evaluate the effect of vascular anatomical variations on surgical outcomes and identify factors that influence open and minimally invasive surgery (MIS) outcomes. Methods This was a single-center retrospective study involving 123 patients who underwent left pancreatectomy (LP). We analyzed the correlation between vascular anatomical variations, namely, (i) the root of the splenic artery (SpA; types 1 and 2), (ii) the parent artery of the dorsal pancreatic artery, (iii) confluence patterns of the left gastric vein, and (iv) the inferior mesenteric vein, and surgical outcomes. We also performed a risk analysis of prolonged operation time, considering surgery-related factors. Results SpA type 2 was only significantly associated with longer operation time (p < 0.01) in LP procedures. In all LP cases, the pancreatic resection line (above the portal vein: odds ratio [OR] 3.47; 95% confidence interval [CI] 1.69–11.18; p < 0.01), the SpA type (type 2; OR 2.77; 95% CI 1.16–6.94; p = 0.02), and surgery type (MIS; OR 5.24; 95% CI 2.17–14.00; p < 0.001) were independently associated with prolonged operation times. In open-LP cases, high body mass index (> 24 kg/m2; OR 7.24; 95% CI 1.89–36.34; p < 0.01), tumor location (pancreatic body; OR 6.89; 95% CI 1.79–33.79; p < 0.01), and the SpA type (type 2; OR 5.86; 95% CI 1.72–24.65; p < 0.01) showed significant association with prolonged operations. In MILP cases, sex (male; OR 9.07; 95% CI 2.61–38.65; p < 0.001) and the pancreatic resection line (above the portal vein; OR 4.12; 95% CI 1.18–17.08; p = 0.03) showed significant associations. Conclusions SpA type 2 may negatively affect surgical outcomes. Therefore, it is important to recognize and approach vascular anatomy appropriately. MIS, especially robotic surgery, may be effective in mitigating the negative effects of variations in vascular anatomy. |
| format | Article |
| id | doaj-art-85c96bcbc8fe420f91f649f629ac55d4 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | World Journal of Surgical Oncology |
| spelling | doaj-art-85c96bcbc8fe420f91f649f629ac55d42025-02-09T12:39:51ZengBMCWorld Journal of Surgical Oncology1477-78192025-02-0123111010.1186/s12957-025-03700-wEffect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective studyMasahiro Fukada0Noriki Mitsui1Takeshi Horaguchi2Yuji Hatanaka3Itaru Yasufuku4Yuta Sato5Jesse Yu Tajima6Shigeru Kiyama7Yoshihiro Tanaka8Katsutoshi Murase9Nobuhisa Matsuhashi10Department of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalDepartment of Gastroenterological Surgery, Gifu University HospitalAbstract Background Minimally invasive left pancreatectomy (MILP) is increasingly performed worldwide, necessitating the need for improved understanding of vascular anatomy during surgery. However, the effect of differences in vascular anatomy on surgical outcomes remains unclear. In this study, we aimed to evaluate the effect of vascular anatomical variations on surgical outcomes and identify factors that influence open and minimally invasive surgery (MIS) outcomes. Methods This was a single-center retrospective study involving 123 patients who underwent left pancreatectomy (LP). We analyzed the correlation between vascular anatomical variations, namely, (i) the root of the splenic artery (SpA; types 1 and 2), (ii) the parent artery of the dorsal pancreatic artery, (iii) confluence patterns of the left gastric vein, and (iv) the inferior mesenteric vein, and surgical outcomes. We also performed a risk analysis of prolonged operation time, considering surgery-related factors. Results SpA type 2 was only significantly associated with longer operation time (p < 0.01) in LP procedures. In all LP cases, the pancreatic resection line (above the portal vein: odds ratio [OR] 3.47; 95% confidence interval [CI] 1.69–11.18; p < 0.01), the SpA type (type 2; OR 2.77; 95% CI 1.16–6.94; p = 0.02), and surgery type (MIS; OR 5.24; 95% CI 2.17–14.00; p < 0.001) were independently associated with prolonged operation times. In open-LP cases, high body mass index (> 24 kg/m2; OR 7.24; 95% CI 1.89–36.34; p < 0.01), tumor location (pancreatic body; OR 6.89; 95% CI 1.79–33.79; p < 0.01), and the SpA type (type 2; OR 5.86; 95% CI 1.72–24.65; p < 0.01) showed significant association with prolonged operations. In MILP cases, sex (male; OR 9.07; 95% CI 2.61–38.65; p < 0.001) and the pancreatic resection line (above the portal vein; OR 4.12; 95% CI 1.18–17.08; p = 0.03) showed significant associations. Conclusions SpA type 2 may negatively affect surgical outcomes. Therefore, it is important to recognize and approach vascular anatomy appropriately. MIS, especially robotic surgery, may be effective in mitigating the negative effects of variations in vascular anatomy.https://doi.org/10.1186/s12957-025-03700-wVascular anatomyRoot of the splenic arteryLeft pancreatectomyMinimally invasive surgeryRobotic surgery |
| spellingShingle | Masahiro Fukada Noriki Mitsui Takeshi Horaguchi Yuji Hatanaka Itaru Yasufuku Yuta Sato Jesse Yu Tajima Shigeru Kiyama Yoshihiro Tanaka Katsutoshi Murase Nobuhisa Matsuhashi Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study World Journal of Surgical Oncology Vascular anatomy Root of the splenic artery Left pancreatectomy Minimally invasive surgery Robotic surgery |
| title | Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study |
| title_full | Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study |
| title_fullStr | Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study |
| title_full_unstemmed | Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study |
| title_short | Effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy: a retrospective study |
| title_sort | effect of differences in vascular anatomy on surgical outcomes of left pancreatectomy a retrospective study |
| topic | Vascular anatomy Root of the splenic artery Left pancreatectomy Minimally invasive surgery Robotic surgery |
| url | https://doi.org/10.1186/s12957-025-03700-w |
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