The splenic artery may be exposed and ligated above the tail of the pancreas by opening the gastrocolic ligament outside the gastroepiploic arcade and opening the posterior peritoneum of the lesser sac over the vessel. Proximal ligation should be avoided to prevent ischemic pancreatic injury. Preliminary ligation reduces the risk of hemorrhage and allows a large spleen to decompress and shrink, making surgery easier and safer.
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