Splenic preservation in laparoscopic distal pancreatectomy

Abstract

Planned LSPDP had a high splenic preservation rate and was associated with significantly shorter operating time than LDPS. Splenic vessel preservation could be predicted using a tumour cut-off size of 3 cm.

Splenic preservation versus splenectomy in laparoscopic distal pancreatectomy: a propensity score-matched study

“…In this study, splenic preservation was achieved in 80% of intended LSPDP, while splenic preservation rates in laparoscopic cohorts in the literature vary between 29 and 86% [14,16,18]. This variation could be explained by differences in surgeon's experience in performing laparoscopic distal pancreatectomy, the long learning curve [27] as well as the preferred technique of splenic preservation (SVP or WT).…”

“…Nowadays, laparoscopic distal pancreatectomy has become the preferred approach, especially for benign and low-grade malignant lesions [12] [13]. There are a limited number of studies comparing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with laparoscopic distal pancreatectomy with splenectomy (LDPS) and the reported results on postoperative morbidity are inconsistent [14][15][16][17][18]. Moreover, outcomes are likely to be impacted by treatment allocation bias due to the retrospective nature of the studies and the conversion from LSPDP to LDPS due to intraoperative events.…”

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

“…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.…”

“…In the LWT group, 48 (24.9%) of 193 patients showed splenic infarction (symptomatic or asymptomatic). Meta-analysis showed the ratio of splenic infarction was [13,19,20,22,29] significantly lower in the LSVP group compared with in the LWT group (OR 0.14; 95% CI: 0.08, 0.26), and there was no heterogeneity between the trials (P = 0.97;…”

Laparoscopic duodenum and spleen-preserving total pancreatectomy: A novel surgical technique for pancreatic intraductal papillary mucinous neoplasms

“…However, function-preserving surgery, such as pyloruspreserving pancreatoduodenectomy, is widely used for benign, potentially malignant and even malignant tumors of the pancreas (7). Laparoscopic spleenpreserving distal pancreatectomy and laparoscopic duodenum-preserving pancreatic head resection (8,9) have been reported to treat benign or low-grade malignant tumors respectively.…”