Postoperative risk of pancreatic fistula after distal pancreatectomy with or without spleen preservation

Tumori. 2021 Apr;107(2):160-165. doi: 10.1177/0300891620936744. Epub 2020 Jul 8.

Abstract

Introduction: Outcomes after distal pancreatectomy with or without splenectomy are controversial. The present study aims to investigate differences in short-term and long-term outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS).

Methods: In this retrospective review of consecutive patients undergoing distal pancreatectomy with or without splenectomy from January 2011 until December 2017 for benign disease, the primary endpoint was to compare postoperative pancreatic fistula (POPF). The secondary endpoint was to compare duration of surgery, intraoperative blood loss, postoperative complications, length of hospital stay, and long-term outcomes.

Results: Patients undergoing SPDP had a lower rate of POPF (13.6% vs 46.1%; p = 0.02). Patients undergoing SPDP (n = 22) were discharged earlier than patients undergoing DPS (n = 26) (8 [4-29] vs 12 [6.48] days; p = 0.003). No differences in other intraoperative and postoperative outcomes were found between groups.

Conclusion: Patients undergoing SPDP developed fewer POPF and were discharged earlier compared to patients undergoing DPS.

Keywords: Pancreatic surgery; distal pancreatectomy; hepato-biliary surgery; spleen preserving; splenectomy.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Organ Sparing Treatments / adverse effects
  • Organ Sparing Treatments / methods*
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Fistula / diagnosis*
  • Pancreatic Fistula / etiology
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Splenectomy / adverse effects
  • Splenectomy / methods*