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A Prognostic Impact of Splenectomy in Laparoscopic Distal Pancreatectomy on Benign/Borderline Pancreatic Tumors: A Change of the Era

Authors
 Seung Soo Hong  ;  Sung Whan Cha  ;  Ho Kyoung Hwang  ;  Woo Jung Lee  ;  Chang Moo Kang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.63(6) : 564-569, 2022-06 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2022-06
MeSH
Humans ; Laparoscopy* / adverse effects ; Laparoscopy* / methods ; Pancreatectomy / adverse effects ; Pancreatectomy / methods ; Pancreatic Neoplasms* / pathology ; Pancreatic Neoplasms* / surgery ; Postoperative Complications / etiology ; Prognosis ; Retrospective Studies ; Splenectomy / adverse effects ; Splenectomy / methods
Keywords
Laparoscopic ; chronologic change ; distal pancreatectomy ; spleen preserving ; surgical outcomes
Abstract
Purpose: In the past, spleen preservation during distal pancreatectomy (DP) was preferred; however, more recent studies reported comparable results between splenectomy and spleen preserving. We retrospectively reviewed patients in a single center who underwent laparoscopic DP with/without splenectomy, and evaluated the chronologic changes of surgical outcomes of the two procedures.

Materials and methods: Patients who underwent laparoscopic DP with or without splenectomy due to benign/borderline tumor from 2005 to 2019 were included in this study. We divided this period into Era 1 (2005-2012) and Era 2 (2013-2019), and compared the chronological evolution of surgical outcomes of laparoscopic distal pancreatosplenectomy (LDPS) to those of laparoscopic spleen-preserving distal pancreatectomy (LSpDP), including the long-term postoperative immunologic profiles.

Results: A total of 198 cases were included (LSpDP: 80 cases; LDPS: 118 cases). As the period changed from Era 1 to Era 2, the ratio of LSpDP decreased and the surgical outcomes of LDPS improved. In Era 1, LSpDP group showed superior results compared to LDPS group in terms of hospital days and postoperative pancreatic fistula ratio; however, in Era 2, the surgical outcomes showed no statistical differences. No significant differences were observed in all of the immunologic markers.

Conclusion: We carefully conclude that during laparoscopic DP, combined splenectomy can be equivalent to spleen preserving in surgical and immunological outcomes, and inevitable splenectomy can be safely conducted.
Files in This Item:
T202202124.pdf Download
DOI
10.3349/ymj.2022.63.6.564
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hong, Seung Soo(홍승수)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188592
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