BACKGROUND There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT). METHODS Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using an suprapancreatic approach and type D using a dorsal approach. RESULTS Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery. CONCLUSION The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.

中文翻译：

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腹腔镜远端胰腺切除术中脾动脉解剖的个性化程序。

背景技术在腹腔镜远端胰腺切除术（LDP）期间选择最合适的脾动脉解剖方法尚无确定的标准。这项研究的目的是根据术前三维计算机断层扫描（3D-CT）可视化的动脉结构变化，评估LDP脾动脉解剖的个性化程序的临床益处。方法回顾性评估在3D-CT后在单个中心接受LDP的患者。3D-CT图像用于构建虚拟3D腹腔镜图像以进行手术计划。脾动脉被分为两种主要的解剖类型：弯曲并在胰腺上方运行的S型和直向胰腺背侧运行的D型。根据这两个变化计划了脾动脉解剖 使用胰上方法切开S型，使用背侧切开D型。结果30例患者进行了类型特异性解剖：S型25例（83％），D型脾动脉解剖5例（17％）。在25例（83％）患者中，已使用计划的手术程序成功解剖了脾动脉，而5例（17％）由于难以解剖脾动脉而不得不更改手术计划。结论根据在3D-CT图像上可视化的解剖变化进行的脾动脉解剖的个性化程序有助于提高LDP的成功率和安全性。在25例（83％）患者中，已使用计划的手术程序成功解剖了脾动脉，而5例（17％）由于难以解剖脾动脉而不得不更改手术计划。结论根据在3D-CT图像上可视化的解剖变化进行的脾动脉解剖的个性化程序有助于提高LDP的成功率和安全性。在25例（83％）患者中，已使用计划的手术程序成功解剖了脾动脉，而5例（17％）由于难以解剖脾动脉而不得不更改手术计划。结论根据在3D-CT图像上可视化的解剖变化进行的脾动脉解剖的个性化程序有助于提高LDP的成功率和安全性。