J Minim Invasive Surg.  2019 Mar;22(1):18-22. 10.7602/jmis.2019.22.1.18.

Spleen Preservation in Laparoscopic Distal Pancreatectomy for Solid Pseudopapillary Neoplasm is Oncologically Safe

Affiliations
  • 1Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. yoonys@snubh.org

Abstract

PURPOSE
Laparoscopic distal pancreatectomy (LDP) has been widely performed for solid pseudopapillary neoplasm (SPN) involving the body or tail of the pancreas. However, it has not been established whether spleen preservation in LDP is oncologically safe for the treatment of SPN with malignant potential. In this study, we compared the short- and long-term outcomes between patients with SPN who underwent laparoscopic spleen-preserving distal pancreatectomy (LSPDP) vs laparoscopic distal pancreatectomy with splenectomy (LDPS).
METHODS
We retrospectively reviewed the medical records of 46 patients with SPN who underwent LDP between January 2005 and November 2016. Patients were divided into 2 groups according to spleen preservation: the LSPDP group (n=32) and the LDPS group (n=14). Clinicopathologic characteristics and perioperative outcomes were compared between groups.
RESULTS
There were no significant differences in pathologic variables, including tumor size, tumor location, node status, angiolymphatic invasion, or perineural invasion between groups. Median operating time was significantly longer in the LSPDP group vs the LDPS group (243 vs 172 minutes; p=0.006). Estimated intraoperative blood loss was also significantly greater in the LSPDP group (310 vs 167 ml; p=0.063). There were no significant differences in incidence of postoperative complications (≥ Clavien-Dindo class IIIa) or pancreatic fistula between groups. After a median follow-up of 35 months (range, 3S153 months), there was no recurrence or disease-specific mortality in either group.
CONCLUSION
The results show that LSPDP is an oncologically safe procedure for SPN involving the body or tail of the pancreas.

Keyword

Laparoscopic distal pancreatectomy; Spleen preservation; Solid pseudopapillary neoplasm

MeSH Terms

Follow-Up Studies
Humans
Incidence
Medical Records
Mortality
Pancreas
Pancreatectomy*
Pancreatic Fistula
Postoperative Complications
Recurrence
Retrospective Studies
Spleen*
Splenectomy
Tail
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