{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:13:04Z","timestamp":1784128384630,"version":"3.55.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The purpose of this study was to investigate the risk factors for splenic vessel preservation in laparoscopic Kimura procedure and to establish and validate a nomogram model for predicting the failure of splenic vessel preservation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      Clinical data of 169 patients who underwent spleen-preserving distal pancreatectomy for benign or low-grade malignant tumors of the distal pancreas at the Affiliated Hospital of Qingdao University from July 2018 to April 2024 were retrospectively collected. Among them, there were 55 male and 114 female individuals, with an average age of 48.24 \u00b1 14.62 years. All patients were planned to undergo laparoscopic Kimura procedure on the basis of preoperative discussions. A total of 118 patients (69.82%) were randomly assigned to the modeling group, and 51 patients (30.18%) to the validation group. No significant differences were observed in baseline characteristics between the two groups (all\n                      <jats:italic>P<\/jats:italic>\n                      &gt; 0.05). On the basis of data from the modeling group, independent risk factors for splenic vessel preservation were identified using rank sum test and multivariate logistic regression analysis. R software was used to establish a nomogram model for predicting the failure of splenic vessel preservation, and external validation was performed using data from the validation group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On the basis of data from the modeling group, the cutoff values of tumor volume, ratio of splenic vein (SV) circumference embedded in pancreas, and pancreas\u2013SV contact area were determined using receiver operating characteristic curves as follows: 9828.8 mm\n                      <jats:sup>3<\/jats:sup>\n                      [area under the curve (AUC) = 0.745, 95% confidence interval (CI) 0.654\u20130.835], 0.45 (AUC = 0.751, 95% CI 0.610\u20130.893), and 501 mm\n                      <jats:sup>2<\/jats:sup>\n                      (AUC = 0.715, 95% CI 0.588\u20130.903), respectively. The AUC for tumor location was 0.733 (95% CI 0.622\u20130.874). Univariate and multivariate logistic regression analyses showed that tumor volume, tumor location, ratio of SV circumference embedded in pancreas, and pancreas\u2013SV contact area were valuable preoperative indicators for predicting the failure of splenic vessel preservation (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). The nomogram prediction model established using R software on the basis of these four indicators exhibited good predictive performance, with C-indices of 0.747 in the modeling group and 0.756 in the validation group. Decision curve analysis indicated that the nomogram model had favorable clinical benefits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tumor volume, tumor location, ratio of SV circumference embedded in pancreas, and pancreas\u2013SV contact area are valuable preoperative indicators for predicting the risk of splenic vessel preservation failure. The nomogram model established on the basis of these indicators has certain clinical practical value. As a representative of the integration of medicine and engineering, three-dimensional medical reconstruction can provide an important reference for the selection of surgical procedures in laparoscopic spleen-preserving distal pancreatectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-18548-3","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:25:53Z","timestamp":1760369153000},"page":"2598-2608","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Kimura or Warshaw? Development and Validation of a Preoperative Prediction Model Based on 3D Reconstruction Technology"],"prefix":"10.1245","volume":"33","author":[{"given":"Hongliang","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qisheng","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lunan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxing","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabo","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuandong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"issue":"1","key":"18548_CR1","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1002\/jhbp.1071","volume":"29","author":"D Ban","year":"2022","unstructured":"Ban D, Nishino H, Ohtsuka T, et al. International expert consensus on precision anatomy for minimally invasive distal pancreatectomy: PAM-HBP surgery project. J Hepatobiliary Pancreat Sci. 2022;29(1):161\u201373.","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"5","key":"18548_CR2","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1001\/archsurg.1988.01400290032004","volume":"123","author":"AL Warshaw","year":"1988","unstructured":"Warshaw AL. Conservation of the spleen with distal pancreatectomy. Arch Surg. 1988;123(5):550\u20133.","journal-title":"Arch Surg"},{"issue":"5","key":"18548_CR3","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1016\/S0039-6060(96)80099-7","volume":"120","author":"W Kimura","year":"1996","unstructured":"Kimura W, Inoue T, Futakawa N, et al. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. Surgery. 1996;120(5):885\u201390.","journal-title":"Surgery"},{"key":"18548_CR4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.ijsu.2017.07.078","volume":"45","author":"H Yongfei","year":"2017","unstructured":"Yongfei H, Javed AA, Burkhart R, et al. Geographical variation and trends in outcomes of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessel preservation: a meta-analysis. Int J Surg. 2017;45:47\u201355.","journal-title":"Int J Surg"},{"issue":"2","key":"18548_CR5","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1245\/s10434-015-4870-z","volume":"23","author":"N Shi","year":"2016","unstructured":"Shi N, Liu SL, Li YT, et al. Splenic preservation versus splenectomy during distal pancreatectomy: a systematic review and meta-analysis. Ann Surg Oncol. 2016;23(2):365\u201374.","journal-title":"Ann Surg Oncol"},{"issue":"6","key":"18548_CR6","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/j.jamcollsurg.2009.08.021","volume":"209","author":"D Borja-Cacho","year":"2009","unstructured":"Borja-Cacho D, Al-Refaie WB, Vickers SM, et al. Laparoscopic distal pancreatectomy. J Am Coll Surg. 2009;209(6):758\u201365.","journal-title":"J Am Coll Surg"},{"key":"18548_CR7","first-page":"492","volume":"07","author":"Y Liu","year":"2022","unstructured":"Liu Y, He X, Chen J, et al. Three-dimensional visualization technology in the use of laparoscopic spleen-preserving distal pancreatectomy. Chin J Gen Surg. 2022;07:492\u20135.","journal-title":"Chin J Gen Surg"},{"issue":"5","key":"18548_CR8","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1097\/SLE.0000000000000804","volume":"30","author":"TK Liao","year":"2020","unstructured":"Liao TK, Wang CJ, Su PJ, et al. Laparoscopic splenic vessels and spleen preservation distal pancreatectomy via inferior-posterior splenic vein approach. Surg Laparosc Endosc Percutan Tech. 2020;30(5):424\u20139.","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"issue":"8","key":"18548_CR9","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1002\/jhbp.849","volume":"28","author":"HT Zhou","year":"2021","unstructured":"Zhou HT, Peng CB, Han Y, et al. Quantitative analysis of three-dimensional reconstruction data to guide the selection of methods for laparoscopic distal pancreatectomy. J Hepatobiliary Pancreat Sci. 2021;28(8):659\u201370.","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"18548_CR10","first-page":"36","volume":"01","author":"Z Zhou","year":"2017","unstructured":"Zhou Z, Zhang Z, Tong D, et al. Clinical study on splenic infarction after spleen-preserving distal pancreatectomy. Chin J Hepatobiliary Surg. 2017;01:36\u20139.","journal-title":"Chin J Hepatobiliary Surg"},{"issue":"3","key":"18548_CR11","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1001\/jamasurg.2013.768","volume":"148","author":"A Jean-Philippe","year":"2013","unstructured":"Jean-Philippe A, Alexandre J, Christophe L, et al. Laparoscopic spleen-preserving distal pancreatectomy: splenic vessel preservation compared with the Warshaw technique. JAMA Surg. 2013;148(3):246\u201352.","journal-title":"JAMA Surg"},{"issue":"4","key":"18548_CR12","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1002\/bjs.10434","volume":"104","author":"M Dai","year":"2017","unstructured":"Dai M, Shi N, Xing C, et al. Splenic preservation in laparoscopic distal pancreatectomy. J Br Surg. 2017;104(4):452\u201362.","journal-title":"J Br Surg"},{"issue":"12","key":"18548_CR13","doi-asserted-by":"publisher","first-page":"E143","DOI":"10.1111\/ans.16310","volume":"90","author":"J Xu","year":"2020","unstructured":"Xu J, Zhan H, Li F, et al. Application of a preoperative image scoring system in laparoscopic spleen-preserving distal pancreatectomy. ANZ J Surg. 2020;90(12):E143\u20137.","journal-title":"ANZ J Surg"}],"container-title":["Annals of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-18548-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1245\/s10434-025-18548-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-18548-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:39:10Z","timestamp":1770899950000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1245\/s10434-025-18548-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["18548"],"URL":"https:\/\/doi.org\/10.1245\/s10434-025-18548-3","relation":{},"ISSN":["1068-9265","1534-4681"],"issn-type":[{"value":"1068-9265","type":"print"},{"value":"1534-4681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,13]]},"assertion":[{"value":"4 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflict of interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"Written informed consent for publication was obtained from all participants in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This study was approved by the Ethics Committee of the Affiliated Hospital of Qingdao University (approval no.: QYFY-WZLL-30367), and informed consent was obtained from all patients and their families.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}