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World Journal of Surgery
Published in: World Journal of Surgery 2/2007

01-02-2007

Spleen-preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein: A Case-matched Comparison with Conventional Distal Pancreatectomy with Splenectomy

Authors: Nicolas Carrère, MD, Skander Abid, MD, Charles Henri Julio, MD, Eric Bloom, MD, Bernard Pradère, MD

Published in: World Journal of Surgery | Issue 2/2007

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Abstract

Background

The value of spleen preservation during distal pancreatectomy (DP) still remains controversial. Spleen-preserving DP with excision of the splenic artery and vein is a simplified technique for spleen preservation. The aim of this study was to compare the postoperative course of DP with or without splenectomy.

Patients and Methods

From 1990 to 2005, 38 consecutive patients with benign or low-grade malignant disease underwent a spleen-preserving DP operation with excision of the splenic artery and vein (Conservative Group). They were compared with 38 patients who underwent conventional DP with splenectomy over the same time period (Splenectomy Group) and who had been matched for age, American Society of Anesthesiologists (ASA) score, and pathological diagnosis. Postoperative courses were analyzed and compared between the Conservative Group and Splenectomy Group.

Results

Spleen preservation was effective in 36 of the 38 attempts (95%). Postoperative complications – in particular, infectious intra-abdominal complications – were significantly higher in the Splenectomy Group (34 and 18%, respectively) than in the Conservative Group (13 and 3%, respectively) (P = 0.03 and P = 0.02, respectively). The length of the surgery, perioperative blood loss or transfusions, perioperative mortality and length of hospital stay did not differ between the two groups. Univariate analysis showed that splenectomy was the only risk factor for postoperative complication.

Conclusions

Spleen-preserving DP with excision of the splenic artery and vein is a fast, safe and effective procedure associated, in this series, with a reduction of postoperative complications relative to conventional DP with splenectomy. This technique should be considered in patients with benign or low-grade malignant disease of the pancreas.
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Metadata
Title
Spleen-preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein: A Case-matched Comparison with Conventional Distal Pancreatectomy with Splenectomy
Authors
Nicolas Carrère, MD
Skander Abid, MD
Charles Henri Julio, MD
Eric Bloom, MD
Bernard Pradère, MD
Publication date
01-02-2007
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 2/2007
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-006-0425-6

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