J Korean Med Sci.  2008 Dec;23(6):1011-1014. 10.3346/jkms.2008.23.6.1011.

Clinical Comparison of Distal Pancreatectomy with or without Splenectomy

• Lee SE
• Jang JY
• Lee KU
• Kim SW

• KMID: 1107526
• DOI: http://doi.org/10.3346/jkms.2008.23.6.1011

Abstract

The spleen may be preserved during distal pancreatectomy (DP) for benign disease. The aim of this study was to compare the perioperative and postoperative courses of patients with conventional DP and spleen-preserving distal pancreatectomy (SPDP) for benign lesions or tumors with low-grade malignant potential occurred at the body or tail of the pancreas. A retrospective analysis was performed for the hospital records of all the patients undergoing DP and SPDP between January 1995 and April 2006. One-hundred forty-three patients underwent DP and 37 patients underwent SPDP. There were no significant differences in age, sex, indications of operation, estimated blood loss, operative time, and postoperative hospital stay between the two groups. Pancreatic fistula occurred in 21 (13.3%) patients following DP and in 3 (8.1%) following SPDP without a significant difference (p=0.081). Portal vein thrombosis occurred in 4 patients after DP. Splenic infarction occurred in one patient after SPDP. Overwhelming postosplenectomy infection was observed in one patient after DP. SPDP can be achieved with no increase in complication rate, operative time, or length of postoperative hospitalization as compared to conventional DP. Additionally, it has the advantage of reducing the risk of overwhelming postsplenectomy infection and postoperative venous thrombosis.

Keyword

Pancreatectomy; Spleen; Organ Preservation

MeSH Terms

Adult
Aged
Female
Humans
Male
Middle Aged
Pancreatectomy/adverse effects/*methods
Pancreatic Fistula/etiology
Pancreatic Neoplasms/pathology/*surgery
Postoperative Complications
Retrospective Studies
*Splenectomy
Treatment Outcome

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