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Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis

Title
Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis
Authors
Sung Hoon Choi;Mi Ae Seo;Woo Jung Lee;Chang Moo Kang;Ho Kyoung Hwang
Issue Date
2012
Journal Title
Surgical Endoscopy and Other Interventional Techniques
ISSN
0930-2794
Citation
Surgical Endoscopy and Other Interventional Techniques, Vol.26(11) : 3149~3156, 2012
Abstract
BACKGROUND: Despite the emphasis on its role, the spleen has commonly been removed in distal pancreatectomy. We designed this study to evaluate the efficacy of spleen salvage during laparoscopic distal pancreatectomy for patients with benign and borderline malignant tumors. MATERIALS AND METHODS: From February 2005 to December 2010, 40 patients underwent spleen-preserving laparoscopic distal pancreatectomy (Sp-Lap DP) and 32 patients underwent laparoscopic distal pancreatosplenectomy (Lap DPS). Medical records were retrospectively reviewed, and a specially designed questionnaire was administered to the patients for the follow-up study. RESULTS: The demographics and final diagnoses were similar between the two groups. The operative time was significantly longer in the Sp-Lap DP group (303.9 ± 136.0 versus 239.0 ± 94.9 min, p = 0.024). Patients in the Lap DPS group had more postoperative pancreatic fistulas of higher grade (p = 0.026). A higher grade of postoperative complications occurred more frequently in the Lap DPS group (p = 0.003). Consequently, postoperative hospital stay was significantly shorter for Sp-Lap DP than for Lap DPS patients (7.1 ± 2.3 versus 12.5 ± 10.8 days, p = 0.004). On the follow-up survey, episodes of common cold or flu were apparently more frequent in the Lap DPS group (p = 0.026). Despite the similar recovery period between the two groups, significantly more patients who underwent Lap DPS felt fatigue (p = 0.014) and poorer health condition (p = 0.042). CONCLUSIONS: In addition to frequent higher-grade complications and prolonged hospital stays, Lap DPS appeared to impair patient quality of life based on follow-up survey. Even an effort to preserve adult spleen in distal pancreatectomy is worthwhile.
URI
http://link.springer.com/article/10.1007%2Fs00464-012-2306-4

http://ir.ymlib.yonsei.ac.kr/handle/22282913/91903
DOI
10.1007/s00464-012-2306-4
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Surgery
Yonsei Authors
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