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

Authors
 Sung Hoon Choi  ;  Mi Ae Seo  ;  Ho Kyoung Hwang  ;  Chang Moo Kang  ;  Woo Jung Lee 
Citation
 Surgical Endoscopy , Vol.26(11) : 3149-3156, 2012 
Journal Title
 Surgical Endoscopy  
ISSN
 0930-2794 
Issue Date
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
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91903
Full Text
http://link.springer.com/article/10.1007%2Fs00464-012-2306-4
DOI
10.1007/s00464-012-2306-4
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
강창무(Kang, Chang Moo)
이우정(Lee, Woo Jung)
최성훈(Choi, Sung Hoon)
황호경(Hwang, Ho Kyoung)
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