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Open Access 01-03-2020 | Splenectomy

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

Authors: Alma L. Moekotte, Sanne Lof, Steve A. White, Ravi Marudanayagam, Bilal Al-Sarireh, Sakhanat Rahman, Zahir Soonawalla, Mark Deakin, Somaiah Aroori, Basil Ammori, Dhanny Gomez, Gabriele Marangoni, Mohammed Abu Hilal, For the Minimally Invasive liver and Pancreatic Surgery Study Group-UK (MI-LAPS UK)

Published in: Surgical Endoscopy | Issue 3/2020

Abstract

Background

The laparoscopic approach in distal pancreatectomy is associated with higher rates of splenic preservation compared to open surgery. Although favorable postoperative short-term outcomes have been reported in open spleen-preserving distal pancreatectomy when compared to distal pancreatectomy with splenectomy, it is unclear whether this observation applies to the laparoscopic approach. The aim of this study is to compare laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with laparoscopic distal pancreatectomy with splenectomy (LDPS).

Study design

This is a UK wide, propensity score-matched study, including patients who underwent LSPDP or LDPS between 2006 and 2016. Short-term outcomes were compared between LSPDP and LDPS according to intention to treat. Additionally, risk factors for unplanned splenectomy were explored.

Results

A total of 456 patients were included from eleven centers (229 LSPDP and 227 LDPS). We were able to match 173 LSPDP cases to 173 LDPS cases, according to intention to treat. No differences were seen in postoperative morbidity between the groups. The only identified risk factor for unplanned splenectomy was tumor size ≥ 30 mm.

Conclusions

Preserving the spleen during laparoscopic distal pancreatectomy is not associated with a lower postoperative morbidity compared to sacrificing the spleen. Tumor size is a risk factor for unplanned splenectomy.

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Title: Splenic preservation versus splenectomy in laparoscopic distal pancreatectomy: a propensity score-matched study
Authors: Alma L. Moekotte
Sanne Lof
Steve A. White
Ravi Marudanayagam
Bilal Al-Sarireh
Sakhanat Rahman
Zahir Soonawalla
Mark Deakin
Somaiah Aroori
Basil Ammori
Dhanny Gomez
Gabriele Marangoni
Mohammed Abu Hilal
For the Minimally Invasive liver and Pancreatic Surgery Study Group-UK (MI-LAPS UK)
Publication date: 01-03-2020
Publisher: Springer US
Keywords: Splenectomy
Pancreatectomy
Splenectomy
Neuroendocrine Tumor
Published in: Surgical Endoscopy / Issue 3/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06901-z

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Springer Medicine

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

Abstract

Background

Study design

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Study design

Results

Conclusions

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