Skip to main content

Advertisement

SpringerLink
Log in

Comparison of clinical outcomes and quality of life between laparoscopic distal pancreatectomy with or without spleen preservation

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The studies comparing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and laparoscopic distal pancreatosplenectomy (LDPS) are limited. This study aimed to compare clinical outcomes and quality of life of patients undergoing LSPDP and LDPS.

Methods

Between March 2004 and December 2014, patients who underwent laparoscopic distal pancreatectomy were reviewed. Patients were divided into 2 groups as LSPDP and LDPS. Data considered for comparison analysis were patient demographics, intraoperative variables, morbidity, postoperative hospital stay, mortality, pathologic findings, and quality of life (SF-36 questionnaire).

Results

A total of 110 patients (50 LSPDP and 60 LDPS) were included in the final analysis. Baseline characteristics were similar in the 2 groups. The LSPDP group had a significantly shorter operative time(153.3 ± 46.2 vs. 179.9 ± 54.1 min, p = 0.015) than the LDPS group. Also in analysis of propensity-matched population(LSPDP:LDPS = 35:35, 1:1 matching), LSPDP group still had a significantly shorter operative time (159.3 ± 36.2 vs. 172.9 ± 44.1 min, p = 0.045) than the LDPS group.There were no significant differences with respect to estimated blood loss, first flatus time, diet start time, and postoperative hospital stay. Postoperative outcomes, including morbidity, pancreatic fistula rates, and mortality, were similar in the LSPDP and LDPS group. On the follow-up survey, the total quality of life score (635.8 ± 50.7 vs. 596.1 ± 92.1)was higher in the LSPDP group compared with the LDPS group. However, the differences were not statistically significant(p > 0.05). The score in vitality (82.5 ± 14.4 vs. 68.9 ± 11.4, p = 0.046) was significantly higher in LSPDP group and not statistically significant in other areas (p > 0.05).Similar results of quality of life assessment were found in analysis of propensity-matched population.

Conclusions

Compared to LDPS, LSPDP had shorter operating time and better quality of life with similar morbidity and recovery period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Di Sabatino A, Carsetti R, Corazza GR (2011) Post-splenectomy and hyposplenic states. Lancet 378(9785):86–97

    Article  Google Scholar 

  2. Kristinsson SY, Gridley G, Hoover RN et al (2014) Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up. Haematologica 99(2):392–398

    Article  Google Scholar 

  3. Shi N, Liu S-L, Li Y-T et al (2016) Splenic preservation versus splenectomy during distal pancreatectomy: a systematic review and meta-analysis. Ann Surg Onco 23(2):365–374

    Article  Google Scholar 

  4. Kooby DA, Vollmer CM (2015) Laparoscopic versus open distal pancreatectomy: is a randomized trial necessary? J Hepatobiliary Pancreat Sci 22(10):737–739

    Article  Google Scholar 

  5. Mehrabi A, Hafezi M, Arvin J et al (2015) A systematic review and meta-analysis of laparoscopic versus open distal pancreatectomy for benign and malignant lesions of the pancreas: it's time to randomize. Surgery 157(1):45–55

    Article  Google Scholar 

  6. Nau P, Melvin WS, Narula VK et al (2009) Laparoscopic distal pancreatectomy with splenic conservation: an operation without increased morbidity. Gastroenterol Res Pract 2009:846340

    Article  Google Scholar 

  7. Zhao YP, Du X, Dai M-H et al (2012) Laparoscopic distal pancreatectomy with or without splenectomy: spleen-preservation does not increase morbidity. Hepatobiliary Pancreat Dis Int 11(5):536–541

    Article  Google Scholar 

  8. Choi SH, Mi AS, Hwang HK et al (2012) Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis. Surg Endosc 26(11):3149–3156

    Article  Google Scholar 

  9. Jiang C, Lv G-Y, Wang Y-C et al (2015) Comparison of Laparoscopic Distal Pancreatectomy with or without Splenic Preservation. Indian J Surg 77(Suppl 3):783–787

    Article  Google Scholar 

  10. Panda N, Bansal NK, Narsimhan M et al (2016) Spleen-preserving versus spleen-sacrificing distal pancreatectomy in laparoscopy and open method-perioperative outcome analysis—14 years experience. Indian J Surg 78(2):90–95

    Article  Google Scholar 

  11. Kwon W, Jang J-Y, Kim JH et al (2016) An analysis of complications, quality of life, and nutritional index after laparoscopic distal pancreatectomy with regard to spleen preservation. J Laparoendosc Adv Surg Tech A 26(5):335–342

    Article  Google Scholar 

  12. Dai MH, Shi N, Xing C et al (2017) Splenic preservation in laparoscopic distal pancreatectomy. Br J Surg 104(4):452–462

    Article  Google Scholar 

  13. Pais-Costa SR, Sousa GCC, Araujo SLM et al (2019) Laparoscopic distal pancreatectomy with or without spleen preservation:comparative analysis of short and long-term outcomeS. Arq Bras Cir Dig 32(3):e1461

    Article  Google Scholar 

  14. Moekotte AL, Lof S, White SA et al (2020) Splenic preservation versus splenectomy in laparoscopic distal pancreatectomy: a propensityscore-matched study. Surg Endosc 34(3):1301–1309

    Article  Google Scholar 

  15. Bassi C, Dervenis C, Butturini G et al (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138(1):8–13

    Article  Google Scholar 

  16. Bassi C, Marchegiani G, Dervenis C et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591

    Article  Google Scholar 

  17. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  Google Scholar 

  18. Hirono S, Tani M, Kawai M et al (2009) A central pancreatectomy for benign or low-grade malignant neoplasms. J Gastrointest Surg 13(9):1659–1665

    Article  Google Scholar 

  19. Sullivan M, Karlsson J, Taft C (2002) SF-36 Hälsoenkät: Svensk Manual och Tolkningsguide, 2:a upplagan (Swedish Manual and Interpretation Guide, 2nd edition). Sahlgrenska University Hospital, Gothenburg

    Google Scholar 

  20. Zhang RC, Yan JF, Xu XW et al (2013) Laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor of the pancreas. World J Gastroenterol 19(37):6272–6277

    Article  Google Scholar 

  21. Yan JF, Xu XW, Jin WW et al (2014) Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: a retrospective study. World J Gastroenterol 20(38):13966–13972

    Article  Google Scholar 

  22. Chen K, Pan Y, Mou YP et al (2019) Surgical outcomes of laparoscopic distal pancreatectomy in elderly and octogenarian patients: a single-center, comparative study. Surg Endosc 33(7):2142–2151

    Article  Google Scholar 

  23. Kimura W, Inoue T, Futakawa N et al (1996) Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. Surgery 120(5):885–890

    Article  CAS  Google Scholar 

  24. Warshaw AL (1988) Conservation of the spleen with distal pancreatectomy. Arch Surg 123(5):550–553

    Article  CAS  Google Scholar 

  25. Gagner M, Pomp A, Herrera MF (1996) Early experience with laparoscopic resections of islet cell tumors. Surgery 120(6):1051–1054

    Article  CAS  Google Scholar 

  26. Nakata K, Shikata S, Ohtsuka T et al (2018) Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta-analysis. J Hepatobiliary Pancreat Sci 25(11):476–488

    Article  Google Scholar 

  27. Adam JP, Jacquin A, Laurent C et al (2013) Laparoscopic spleen-preserving distal pancreatectomy: splenic vessel preservation compared with the Warshaw technique. JAMA Surg 148(3):246–252

    Article  Google Scholar 

  28. Wang L, Wu D, Cheng YG et al (2019) Warshaw technique in laparoscopic spleen-preserving distal pancreatectomy: surgical strategy and late outcomes of splenic preservation. BioMed Res Int 2019:4074369

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Key Laboratory of Gastroenterology of Zhejiang Province, People’s Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang Province, China

    Ren-Chao Zhang, Jun Ma, Yi-Ping Mou & Yu-Cheng Zhou

  2. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang Province, China

    Jia-Fei Yan

Authors
  1. Ren-Chao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi-Ping Mou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jia-Fei Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yu-Cheng Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yi-Ping Mou.

Ethics declarations

Disclosures

Ren-Chao Zhang, Jun Ma, Yi-Ping Mou, Jia-Fei Yan, and Yu-Cheng Zhou have no conflict of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, RC., Ma, J., Mou, YP. et al. Comparison of clinical outcomes and quality of life between laparoscopic distal pancreatectomy with or without spleen preservation. Surg Endosc 35, 3412–3420 (2021). https://doi.org/10.1007/s00464-020-07783-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-07783-2

Keywords

Search

Navigation