Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

Panda, Nilanjan; Bansal, Nitin Kumar; Narsimhan, M.; Ardhanari, Ramesh; Bronson, Joseph Raja B.

doi:10.1007/s12262-015-1324-6

Cited by 11 publications

(6 citation statements)

References 31 publications

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“…Spleen-preserving approach was adopted in younger patients (median 27.5 years) and that observation is consistent with that of the other report [30]. Possible explanation for that was the prevention of any eventual long-term consequences of asplenia.…”

Section: Discussionsupporting

confidence: 85%

Is Central Pancreatectomy Truly Recommendable? A 9-Year Single-Center Experience

Qian

Qiu

et al. 2017

Dig Surg

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Aims: To compare the short- and long-term outcomes in patients with pancreatic benign or borderline neoplasm who underwent central pancreatectomy (CP) and distal pancreatectomy (DP). Methods: The inclusion criteria were as follows: (1) single benign or low-grade malignant tumor; (2) tumor conﬁned to the pancreatic neck or proximal body; and (3) tumor amenable to either CP or DP. Short and long-term outcomes, including complications, pancreatic exocrine and endocrine function, and quality of life (QoL) were analyzed retrospectively. Results: Sixteen patients who underwent CP and 26 patients who underwent DP were included. The median follow-up period was 53 months (range 21–117 months). Patients undergoing CP were significantly more likely to experience complications (68.7 vs. 23%, p = 0.003) especially grade B/C postoperative pancreatic fistula (62.5 vs. 23%, p = 0.011) than those undergoing DP. During the long-term follow-up, 2 patients in the DP group developed new-onset diabetes mellitus, but no patient in CP group developed this condition (8 vs. 0%, p = 0.382). Evidence of exocrine insufficiency, including severe diarrhea or steatorrhea, was not observed in either group. Both groups were equally satisfied with the overall health status and overall QoL. Conclusion: CP is associated with excellent pancreatic function but a significantly increased postoperative morbidity and risk compared to DP. Therefore, the indication of CP should be chosen strictly.

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Section: Discussionsupporting

confidence: 85%

Is Central Pancreatectomy Truly Recommendable? A 9-Year Single-Center Experience

Qian

Qiu

et al. 2017

Dig Surg

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“…The search strategy yielded 411 articles and we checked the title and abstract of the studies according to the inclusion and exclusion criteria and selected 53 articles. After the full texts of the remaining articles were read, 15 articles were included in the meta-analysis of MI-SPDP versus MI-DPS [13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] and 15 articles were included in the meta-analysis of MI-SVP versus MI-WT [13,23,[31][32][33][34][35][36][37][38][39][40][41][42][43]. Figure 1 shows the flow diagram of study identification and evaluation during the review process.…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta‐analysis

Nakata

Shikata

Ohtsuka

et al. 2018

J Hepato Biliary Pancreat

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“…In our center, we usually do pylorus-preserving pancreatoduodenectomy and spleen-preserving distal pancreatectomy for benign and low-grade malignant pancreatic tumors and the preserving rates were 100% in our report. However, organ-preserving surgery were controversial and more researches were need to prove the advantages [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic pancreatectomy for benign or low-grade malignant pancreatic tumors: outcomes in a single high-volume institution

2021

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Objective To investigate the perioperative and long-term outcomes of laparoscopic pancreatectomy for benign and low-grade malignant pancreatic tumors, and further compare the outcomes between different surgical techniques. Methods We retrospectively collected clinical data of consecutive patients with benign or low-grade malignant pancreatic tumors underwent surgery from February 2014 to February 2019. Patients were grouped and compared according to different surgical operations they accepted. Results Totally 164 patients were reviewed and 83 patients underwent laparoscopic pylorus-preserving pancreaticoduodenectomy (LPPPD), 41 patients underwent laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and 20 patients underwent laparoscopic central pancreatectomy (LCP) were included in this study, the rest 20 patients underwent laparoscopic enucleation were excluded. There were 53 male patients and 91 female patients. The median age of these patients was 53.0 years (IQR 39.3–63.0 years). The median BMI was 21.5 kg/m2 (IQR 19.7–24.0 kg/m2). The postoperative severe complication was 4.2% and the 90-days mortality was 0. Compare with LCP group, the LPPPD and LSPDP group had longer operation time (300.4 ± 89.7 vs. 197.5 ± 30.5 min, P < 0.001) while LSPDP group had shorter operation time (174.8 ± 46.4 vs. 197.5 ± 30.5 min, P = 0.027), more blood loss [140.0 (50.0–1000.0) vs. 50.0 (20.0–200.0) ml P < 0.001 and 100.0 (20.0–300.0) vs. 50.0 (20.0–200.0 ml, P = 0.039, respectively), lower rate of clinically relevant postoperative pancreatic fistula [3 (3.6%) vs. 8 (40.0%), P < 0.001 and 3 (7.3%) vs. 8 (40.0%), P = 0.006, respectively], lower rate of postpancreatectomy hemorrhage [0 (0%) vs. 2 (10.0%), P = 0.036 and (0%) vs. 2 (10.0%) P = 0.104, respectively] and lower rate of postoperative severe complications [2 (2.4%) vs.4 (20.0%), P = 0.012 and 0 (0%) vs. 4 (20.0%), P = 0.009, respectively], higher proportion of postoperative pancreatin and insulin treatment (pancreatin: 39.8% vs., 15% P = 0.037 and 24.4%vs. 15%, P = 0.390; insulin: 0 vs. 18.1%, P = 0.040 and 0 vs. 12.2%, P = 0.041). Conclusions Overall, laparoscopic pancreatectomy could be safely performed for benign and low-grade malignant pancreatic tumors while the decision to perform laparoscopic central pancreatectomy should be made carefully for fit patients who can sustain a significant postoperative morbidity and could benefit from the excellent long-term results even in a high-volume center.

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Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

Cited by 11 publications

References 31 publications

Is Central Pancreatectomy Truly Recommendable? A 9-Year Single-Center Experience

Is Central Pancreatectomy Truly Recommendable? A 9-Year Single-Center Experience

Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta‐analysis

Laparoscopic pancreatectomy for benign or low-grade malignant pancreatic tumors: outcomes in a single high-volume institution

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