{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:44:17Z","timestamp":1792165457018,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":276,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Unexpected vascular lesions may complicate standard laparoscopic pancreatic procedures. We report a case of mucinous cystic neoplasm (MCN) treated with laparoscopic spleen\u2010preserving distal pancreatectomy (LSPDP) in which unrecognized immunoglobulin G4 (IgG4)\u2010related periarteritis of the splenic artery caused difficulty during vascular division. A 76\u2010year\u2010old woman underwent LSPDP for MCN. Preoperative computed tomography demonstrated circumferential soft\u2010tissue thickening along the splenic artery. Intraoperatively, the splenic artery was deeply embedded within the pancreatic parenchyma, making the Kimura technique impractical; therefore, the Warshaw technique was selected. However, the splenic artery demonstrated marked circumferential wall thickening, precluding safe division with ligation or clipping alone. The artery was ultimately divided using a vascular stapler. Histopathological examination revealed low\u2010grade MCN and IgG4\u2010related periarteritis involving the splenic artery. This case highlights that IgG4\u2010related periarteritis should be considered when unexplained perivascular soft\u2010tissue thickening is identified preoperatively, as it may significantly alter intraoperative strategy during LSPDP.<\/jats:p>","DOI":"10.1111\/ases.70387","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:36:53Z","timestamp":1791178613000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Spleen\u2010Preserving Distal Pancreatectomy for Mucinous Cystic Neoplasm With Unexpected Immunoglobulin\n                    <scp>G4<\/scp>\n                    \u2010Related Periarteritis of the Splenic Artery: A Case Report"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6796-1891","authenticated-orcid":false,"given":"Dongha","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9539-0560","authenticated-orcid":false,"given":"Yoshihide","family":"Nanno","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7550-448X","authenticated-orcid":false,"given":"Jun","family":"Ishida","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe 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Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8756-3716","authenticated-orcid":false,"given":"Keisuke","family":"Arai","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9832-5457","authenticated-orcid":false,"given":"Toshihiko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe 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