Open and Laparoscopic Spleen-preserving, Splenic Vessel-preserving Distal Pancreatectomy: Indications and Outcomes

Background Spleen-preserving distal pancreatectomy has been described lately in order to reduce the risks associated with splenectomy. The aim of this study is to report a series of open and laparoscopic distal pancreatectomies with splenic vessel preservation. Methods From June 2001 to April 2007,...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2008-07, Vol.12 (7), p.1202-1206
Main Authors: Bruzoni, Matias, Sasson, Aaron R.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Gastroenterology
Humans
Incidence
Laparoscopy - methods
Laparotomy - methods
Length of Stay
Male
Medical research
Medicine
Medicine & Public Health
Middle Aged
Nebraska - epidemiology
Original Article
Pancreatectomy - methods
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - surgery
Postoperative Complications - epidemiology
Retrospective Studies
Spleen
Spleen - blood supply
Splenic Artery - surgery
Splenic Vein - surgery
Surgery
Time Factors
Treatment Outcome
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Summary:Background Spleen-preserving distal pancreatectomy has been described lately in order to reduce the risks associated with splenectomy. The aim of this study is to report a series of open and laparoscopic distal pancreatectomies with splenic vessel preservation. Methods From June 2001 to April 2007, 11 spleen-preserving distal pancreatectomies were performed, utilizing open and laparoscopic techniques. The main variables recorded were demographics, intra- and postoperative complications, and final pathology results. Results All 11 spleen-preserving distal pancreatectomies were performed successfully. Laparoscopic resection was possible in seven patients. Postoperative morbidity consisted of one pancreatic fluid collection. The overall incidence of pancreatic leak was 18%. The final pathology revealed serous cystadenoma in 36% of the cases, neuroendocrine tumor in two cases, three mucinous cystadenomas, one carcinoid tumor, and one intrapancreatic spleen. With a median follow-up of 26 months, no splenic vein thrombosis was detected. Conclusions Open or laparoscopic spleen-preserving distal pancreatectomy with splenic vessel preservation is a feasible and safe procedure. In selected cases of cystic lesions and low grade neoplasms, distal pancreatectomy with splenic preservation is possible.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-008-0512-0