Comparison of Spleen Preserving Laparoscopic Distal Pancreatectomy with En Bloc Laparoscopic Distal Pancreatectomy

Kang, Sung Hwa; Park, Kwan Tae; Kim, Young Hoon; Seo, Hye Ryun; Han, Duck Jong; Kim, Song Chul

Abstract

PURPOSE: The purpose of this study is to compare the clinical results of spleen preserving laparoscopic distal pancreatectomy (SPLDP) with en bloc laparoscopic distal pancreatectomy (LDP).
METHODS
From March 2005 to August 2008, 52 cases of SPLDP and 84 LDPs were performed at our institution and we retrospectively compared these cases. The enrollment period were chronologically divided to four eras of 10.5 months each.
RESULTS
The demographics, including the patients' age, gender and BMI, were not different between the two groups. The final pathologic diagnosis was diverse, and it included cystic tumor, SPT, IPMT, cancer, endocrine tumor, etc and there was no difference between the two groups. The tumor location, operative time, tumor size, perioperative transfusion requirement, the length of the hospital stay and the postoperative complications were not different between the two groups. The mean operative time was gradually shortened by eras (Era 1: 236.3 min, Era 2: 223.6 min, Era 3: 188.8 min, Era 4: 187.9 min) and the proportion of SPLDP was increased by eras from 1.9% to 9.6%, 42.3% and 46.2%, respectively.
CONCLUSION
SPLDP might be technically more difficult than LDP, and especially in the initial learning stage of performing laparoscopic pancreatic surgery. After overcoming the learning curve, SPLDP can be performed safely and possibly within a shorter time. SPLDP should be tried whenever possible so that the patients get the maximal benefits of minimal invasive surgery and especially for resecting the more distal pancreatic lesions.