| Peer-Reviewed

Laparoscopic Distal Pancreatectomy Preserving the Spleen and Splenic Vessels: An Operation Without Increased Morbidity

Received: 7 June 2019    Accepted: 15 July 2019    Published: 5 August 2019
Views:       Downloads:
Abstract

Background: The indications for laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and the associated morbidity in comparison to laparoscopic distal pancreatectomy with splenectomy (LDPS) are ill-defined. Objective: This study aimed to evaluate the safety, feasibility and outcomes of LSPDP. Methods: Between January 2010 and May 2014, 13 patients underwent LDPS or LSPDP in our institution, and their clinical data and the outcomes of the two procedures were retrospectively reviewed and statistically analyzed. Results: There were no significant differences in age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI) or blood loss between the LDPS and LSPDP groups. The mean tumor size (8.63 vs. 2.51 cm, P<0.005) and mean operative time (353 vs. 235 minutes, P<0.029) were greater in the LDPS group than in the LSPDP group. The rates of complications in the two groups did not differ to a statistically significant extent. All of the patients were achieved R0 resection and no mortality. Conclusion: LSPDP with conservation of the splenic artery and vein was a safe and feasible option for benign or low-grade malignant tumors in the distal pancreas, because of no mortality, no splenic infarction and R0 resection. Splenic conservation does not significantly increase the morbidity associated with the procedure.

Published in Journal of Surgery (Volume 7, Issue 4)
DOI 10.11648/j.js.20190704.15
Page(s) 110-113
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pancreas, Laparoscopy, Distal Pancreatectomy, Spleen-preserving, Splenic Vessels

References
[1] Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicenter randomized controlled trial. Lancet. 2005; 365: 1718-1726.
[2] Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007; 245: 68-72.
[3] Habermaiz B, Sauerland S, Deker G, Delaitre B, Gigot JF, Leandros E, et al. Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2008; 22: 821-848.
[4] Miyajima N, Fukunaga M, Hasegawa H, Tanaka J, Okuda J, Watanabe M. Results of a multicenter study of 1,057 cases of rectal cancer treated by laparoscopic surgery. Surg Endosc. 2009; 23: 113-118.
[5] Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, et al. The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg. 2009; 250: 825-830.
[6] Karaliotas C, Sgourakis G. Laparoscopic versus open enucleation for solitary insulinoma in the body and tail of the pancreas. J Gastrointest Surg. 2009; 13: 1869.
[7] Melotti G, Butturini G, Piccoli M, Casetti L, Bassi C, Mullineris B, et al. Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients. Ann Surg. 2007; 246: 77-82.
[8] Borja-Cacho D, Al-Refaie WB, Vickers SM, Tuttle TM, Jensen EH. Laparoscopic distal pancreatectomy. J Am Coll Surg. 2009; 209: 758-765.
[9] Teh SH, Tseng D, Sheppard BC. Laparoscopic and open distal pancreatic resection for benign pancreatic disease. J Gastrointest Surg. 2007; 11: 1120-1125.
[10] Mabrut JY, Fernandez-Cruz L, Azagra JS, Bassi C, Delvaux G, Weerts J, et al. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005; 137: 597-605.
[11] Shoup M, Brennan MF, McWhite K, Leung DH, Klimstra D, Conlon KC. The value of splenic preservation with distal pancreatectomy. Arch Surg. 2002; 137; 164-168.
[12] Dulucq JL, Wintringer P, Stabilini C, Feryn T, Perissat J, Mahajna A. Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution. Surg Endosc. 2005; 19: 1028-1034.
[13] Carrère N, Abid S, Julio CH, Bloom E, Pradère B. Spleen-preserving distal pancreatectomy with excision of splenic artery and vein: a case-matched comparison with conventional distal pancreatectomy with splenectomy. World J Surg. 2007; 31: 375-382.
[14] Rodríguez JR, Madanat MG, Healy BC, Thayer SP, Warshaw AL, Fernández-del Castillo C. Distal pancreatectomy with spleen preservation revisited. Surgery. 2007; 141: 619-625.
[15] Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005; 138: 8-13.
[16] Holdsworth RJ, Irving AD, Cuschieri A. Postsplenectomy sepsis and its mortality rate: actual versus perceived risks. Br J Surg. 1991; 78: 1031-1038.
[17] Bruzoni M, Sasson AR. Open and laparoscopic spleen-preserving, splenic vessel-preserving distal pancreatectomy: indications and outcomes. J Gastrointest Surg. 2008; 12: 1202-1206.
[18] Vezakis A, Davides D, Larvin M, McMahon MJ. Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors. Surg Endosc. 1999; 13: 26-29.
[19] Shimizu S, Tanaka M, Konomi H, Tamura T, Mizumoto K, Yamaguchi K. Spleen-preserving laparoscopic distal pancreatectomy after division of the splenic vessels. J Laparoendosc Adv Surg Tech A. 2004; 14:173-177.
[20] Fernández-Cruz L, Martínez I, Gilabert R, Cesar-Borges G, Astudillo E, Navarro S. Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. J Gastrointest Surg. 2004; 8: 493-501.
[21] Pryor A, Means JR, Pappas TN. Laparoscopic distal pancreatectomy with splenic preservation. Surg Endosc. 2007; 21: 2326-2330.
Cite This Article
  • APA Style

    Kazuhiro Suzumura, Kenjiro Iida, Hideaki Iwama, Yusuke Kawabata. (2019). Laparoscopic Distal Pancreatectomy Preserving the Spleen and Splenic Vessels: An Operation Without Increased Morbidity. Journal of Surgery, 7(4), 110-113. https://doi.org/10.11648/j.js.20190704.15

    Copy | Download

    ACS Style

    Kazuhiro Suzumura; Kenjiro Iida; Hideaki Iwama; Yusuke Kawabata. Laparoscopic Distal Pancreatectomy Preserving the Spleen and Splenic Vessels: An Operation Without Increased Morbidity. J. Surg. 2019, 7(4), 110-113. doi: 10.11648/j.js.20190704.15

    Copy | Download

    AMA Style

    Kazuhiro Suzumura, Kenjiro Iida, Hideaki Iwama, Yusuke Kawabata. Laparoscopic Distal Pancreatectomy Preserving the Spleen and Splenic Vessels: An Operation Without Increased Morbidity. J Surg. 2019;7(4):110-113. doi: 10.11648/j.js.20190704.15

    Copy | Download

  • @article{10.11648/j.js.20190704.15,
      author = {Kazuhiro Suzumura and Kenjiro Iida and Hideaki Iwama and Yusuke Kawabata},
      title = {Laparoscopic Distal Pancreatectomy Preserving the Spleen and Splenic Vessels: An Operation Without Increased Morbidity},
      journal = {Journal of Surgery},
      volume = {7},
      number = {4},
      pages = {110-113},
      doi = {10.11648/j.js.20190704.15},
      url = {https://doi.org/10.11648/j.js.20190704.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190704.15},
      abstract = {Background: The indications for laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and the associated morbidity in comparison to laparoscopic distal pancreatectomy with splenectomy (LDPS) are ill-defined. Objective: This study aimed to evaluate the safety, feasibility and outcomes of LSPDP. Methods: Between January 2010 and May 2014, 13 patients underwent LDPS or LSPDP in our institution, and their clinical data and the outcomes of the two procedures were retrospectively reviewed and statistically analyzed. Results: There were no significant differences in age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI) or blood loss between the LDPS and LSPDP groups. The mean tumor size (8.63 vs. 2.51 cm, P<0.005) and mean operative time (353 vs. 235 minutes, P<0.029) were greater in the LDPS group than in the LSPDP group. The rates of complications in the two groups did not differ to a statistically significant extent. All of the patients were achieved R0 resection and no mortality. Conclusion: LSPDP with conservation of the splenic artery and vein was a safe and feasible option for benign or low-grade malignant tumors in the distal pancreas, because of no mortality, no splenic infarction and R0 resection. Splenic conservation does not significantly increase the morbidity associated with the procedure.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Laparoscopic Distal Pancreatectomy Preserving the Spleen and Splenic Vessels: An Operation Without Increased Morbidity
    AU  - Kazuhiro Suzumura
    AU  - Kenjiro Iida
    AU  - Hideaki Iwama
    AU  - Yusuke Kawabata
    Y1  - 2019/08/05
    PY  - 2019
    N1  - https://doi.org/10.11648/j.js.20190704.15
    DO  - 10.11648/j.js.20190704.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 110
    EP  - 113
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20190704.15
    AB  - Background: The indications for laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and the associated morbidity in comparison to laparoscopic distal pancreatectomy with splenectomy (LDPS) are ill-defined. Objective: This study aimed to evaluate the safety, feasibility and outcomes of LSPDP. Methods: Between January 2010 and May 2014, 13 patients underwent LDPS or LSPDP in our institution, and their clinical data and the outcomes of the two procedures were retrospectively reviewed and statistically analyzed. Results: There were no significant differences in age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI) or blood loss between the LDPS and LSPDP groups. The mean tumor size (8.63 vs. 2.51 cm, P<0.005) and mean operative time (353 vs. 235 minutes, P<0.029) were greater in the LDPS group than in the LSPDP group. The rates of complications in the two groups did not differ to a statistically significant extent. All of the patients were achieved R0 resection and no mortality. Conclusion: LSPDP with conservation of the splenic artery and vein was a safe and feasible option for benign or low-grade malignant tumors in the distal pancreas, because of no mortality, no splenic infarction and R0 resection. Splenic conservation does not significantly increase the morbidity associated with the procedure.
    VL  - 7
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

  • Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

  • Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

  • Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

  • Sections