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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2025; 17(10): 109774
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.109774
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.109774
Indications and techniques for minimally invasive spleen-preserving distal pancreatectomy
David Gutierrez Blanco, Erin Baker, John B Martinie, Raphael L C Araujo, Department of Surgery, Hepato-pancreato-biliary Service, Carolinas Medical Center, Atrium Health, Charlotte, NC 28204, United States
Marcio Apodaca-Rueda, Carlos T Maeda, Raphael L C Araujo, Department of Surgery, Uni
Camila G C Y Carvalho, Department of Surgical Oncology, Sao Paulo State Employee Hospital, São Paulo 04029-000, São Paulo, Brazil
Author contributions: Gutierrez Blanco D and Araujo RLC performed the research, study design, manuscript preparation; Apodaca-Rueda M, Maeda CT, Carvalho CGCY, Baker E, and Martinie JB contributed to study design, critical revision, and figure generation.
Conflict-of-interest statement: All authors declared no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raphael L C Araujo, MD, PhD, Adjunct Professor, FACS, Department of Surgery, Universidade Federal de São Paulo, R. Napoleão de Barros, 715, São Paulo 04024-002, São Paulo, Brazil. raphael.l.c.araujo@gmail.com
Received: May 21, 2025
Revised: June 7, 2025
Accepted: August 21, 2025
Published online: October 27, 2025
Processing time: 156 Days and 12.2 Hours
Revised: June 7, 2025
Accepted: August 21, 2025
Published online: October 27, 2025
Processing time: 156 Days and 12.2 Hours
Core Tip
Core Tip: Splenectomy is usually performed as part of the distal pancreatectomy procedure due to the organs' close anatomic relationship and the inherent difficulty in separating or preserving the splenic blood supply. Nonetheless, the spleen plays an important role in immunological response, and its preservation has been linked to improvements in overall short- and long-term outcomes. As a result, for benign pancreatic lesions splenic preservation is preferable to standard splenectomy. As minimally invasive distal pancreatectomy has risen in popularity, positive long-term outcomes are largely debated.