对于已接受远段胃切除术（DG）的患者而言，在远程胰腺切除术（DP）期间的最佳操作方法仍然不清楚。关于残余胃缺血的几篇文献报告指出，保存脾血管对于保护近端残余胃至关重要。我们评估了我院对于术后DG患者进行DP的效果，并引入了机器人脾血管保留DP（R-SPDP）。我们评估了2014年至2021年期间术后DG患者进行DP的术后短期效果。接下来，我们对术后DG患者进行了R-SPDP手术，以安全地保护残余胃。我们使用双极电凝法来切割脾血管周围的粘连组织。通过在根部夹闭脾动脉以防止出血。保留并切除了作为残余胃主要供血来源的所有短胃动脉和静脉，完成了切除术。切除后，通过靛青绿（ICG）荧光血管造影来确认短胃动脉和静脉的血液流动以及返回脾静脉的血液回流状况。结果：在接受脾切除术的8例患者中，有4例（50.0%）保留了残余胃，其中1例传统DP病例的ICG灌注较差，术后出现残余胃缺血。ICG灌注良好的R-SPDP病例手术时间为371分钟，术中出血量为10毫升。术后第3天开始口服饮食，术后恢复顺利。R-SPDP对于术后DG患者来说，可以是一种安全地保留残余胃的良好选择。©2023年。外科肿瘤学会。

The optimal procedure during distal pancreatectomy (DP) for patients who have undergone distal gastrectomy (DG) remains unclear. Several papers on remnant gastric ischemia have reported that the preserved splenic vessels are essential for the proximal remnant stomach.1-4 We evaluated the outcomes of DP for post-DG patients in our hospital and introduced robotic splenic vessels preserving DP (R-SPDP).Postoperative short-term outcomes of DP for post-DG patients during 2014 and 2021 were evaluated. Next, R-SPDP was performed for a post-DG patient with the intention of preserving the remnant stomach safely. The double bipolar method was used to dissect the adhesions around the splenic vessels.5,6 The splenic artery was clamped at the root side to prevent bleeding.7 All short gastric arteries and veins, which were the main feeders of the remnant stomach, were preserved and resection was completed. After resection, the indocyanine green (ICG) fluorescence angiography confirmed blood flow in the short gastric arteries and veins and good return blood flow to the splenic vein.8 RESULTS: Of four patients (50.0%, of 8 DP patients) in whom the remnant stomach was preserved, one conventional DP case had poor ICG perfusion and presented with remnant stomach ischemia postoperatively. The R-SPDP case with good ICG perfusion had a total operation time of 371 minutes and intraoperative blood loss of 10 mL. The oral diet was started on postoperative Day 3, and the postoperative course was uneventful.R-SPDP can be a good option for post-DG patients to preserve the remnant stomach safely.© 2023. Society of Surgical Oncology.