Laparoscopic distal pancreatectomy with or without splenectomy: spleen-preservation does not increase morbidity

Hepatobiliary Pancreat Dis Int. 2012 Oct;11(5):536-41. doi: 10.1016/s1499-3872(12)60220-3.

Abstract

Background: The indications for laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and its morbidity compared with laparoscopic distal pancreatectomy with splenectomy (LDPS) are ill-defined. This study aimed to share the indications for spleen-preservation and investigate the safety and outcome of LSPDP at our institution.

Methods: A retrospective review of patients who were scheduled to receive laparoscopic surgery for distal pancreatic lesions was conducted. The indications, surgical procedures, intra-operative data, and outcomes of the two procedures were collected and compared by statistical analysis.

Results: LDPS and LSPDP were successfully performed in 16 and 21 patients respectively, whereas they were converted to open surgery in 9 patients. There were no significant differences in age, gender, operation time, blood loss, and conversion rate between the LDPS and LSPDP groups. The mean tumor size showed an inter-group difference (5.05 vs 2.53 cm, P<0.001). There were no significant differences in complication and morbidity rates between the two groups. All patients remained alive without recurrence during a follow-up of 9 to 67 months (median 35).

Conclusion: LSPDP has a morbidity and outcome comparable to LDPS.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Morbidity
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Fistula / etiology
  • Retrospective Studies
  • Splenectomy / methods*