A study comparing Warshaw vs. Kimura techniques for spleen-preserving distal pancreatectomy shows crucial differences in outcomes.

• Warshaw is preferred for larger tumors (2.5 cm vs. 1.5 cm) and complex cases, while Kimura offers shorter operative times and is more often minimally invasive (73.1% vs. 44.1%).
• Long-term complications like splenic hypoperfusion are more frequent after Warshaw (30.4% vs. 12.2%), though mostly asymptomatic.

Surgeons should choose technique based on tumor characteristics to minimize complications and optimize patient recovery.

• Need for secondary splenectomy is rare at only 1.2%.