Laparoscopic distal pancreatectomy: Does splenic preservation affect outcomes?

Kristin L. Mekeel, Adyr A. Moss, Kunam S. Reddy, David C. Mulligan, Kristi L. Harold

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Although the spleen is often routinely resected during both open and laparoscopic distal pancreatectomies, a splenectomy can increase the risk of postoperative and life-long infectious complications. Spleen-preserving laparoscopic pancreatectomies can technically be more difficult because of the delicate dissection of the splenic vessels. We performed a retrospective review of 34 laparoscopic pancreatectomies done at our institution. All procedures were done laparoscopically without hand assistance. Attempts were made in all patients to conserve the spleen, which was successful in 10 patients (29%). In the splenectomy group, 9 patients had 12 surgical complications (26%), which was statistically significant compared with the spleen-preserving group, in which there were no complications. This included 7 patients with a pancreatic leak (20%) and 3 with postoperative hemorrhage requiring reexploration (9%). Patients with spleen-preserving pancreatectomies had significantly less blood loss and shorter operative time compared with patients who underwent concomitant splenectomy. Splenic preservation should be attempted in all patients undergoing laparoscopic distal pancreatectomy unless there are overriding oncological or anatomic concerns.

Original languageEnglish (US)
Pages (from-to)362-365
Number of pages4
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume21
Issue number5
DOIs
StatePublished - Oct 1 2011

Keywords

  • laparoscopic distal pancreatectomy
  • laparoscopic splenectomy
  • minimally invasive surgery
  • pancreatectomy
  • spleen-preserving

ASJC Scopus subject areas

  • Surgery

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