Splenic Preservation Versus Splenectomy During Distal Pancreatectomy: A Systematic Review and Meta-analysis

• Published in: Annals of surgical oncology 2016-02, Vol.23 (2), p.365-374
• Main Authors: Shi, Ning, Liu, Shang-Long, Li, Ya-Tong, You, Lei, Dai, Meng-Hua, Zhao, Yu-Pei
• Format: Article
• Language: English
• Subjects: Healthcare Policy and Outcomes; Humans; Medicine; Medicine & Public Health; Oncology; Organ Sparing Treatments - methods; Pancreatectomy; Pancreatic Neoplasms - surgery; Splenectomy; Surgery; Surgical Oncology; Treatment Outcome
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-015-4870-z

Background Studies have been published comparing spleen-preserving distal pancreatectomy (SPDP) with distal pancreatectomy with splenectomy (DPS), but the results remain inconsistent.The aim of this study was to compare SPDP with DPS by conducting a systematic review and meta-analysis. Methods Literature searches of the Medline/PubMed, Embase, and Cochrane Library databases were performed to identify relevant studies published before April 30, 2015. Perioperative outcomes of SPDP and DPS were evaluated. The meta-analysis was performed in random- or fixed-effects models, as appropriate. A subanalysis was conducted to compare the two techniques of splenic preservation: splenic vessel preservation (SVP) and Warshaw technique (WT). Results Eighteen studies and 1156 patients were included in the comparison between SPDP and DPS. A total of 502 of these patients underwent SPDP and 654 underwent DPS. Meta-analysis showed the SPDP group had significantly fewer infectious complications (odds ratio [OR] 0.57, P  = 0.006), less operative blood loss ( P