Spleen-preserving Distal Pancreatectomy 28 Cases Report

ObjectiveTo evaluate the feasibility of spleen-preserving distal pancreatectomy.MethodsTo analyze retrospectively 58 cases of distal pancreatectectomy performed from Jan.1999 to June 2009,including 30 patients han distal pancreatectomy with splenectomy(GroupA),28 cases underwent spleen-preservation distal pancreatectomy(Group B),.Group B including splenic vessels preservation (Group B1) and splenic vessels resection(Group B2).The length of operation,intraoperative blood loss,intraoperative blood transfusion,incidence of perioperative complication and postoperative length of hospital stay were compared between Group A and Group B,Group B1 and Group B2.ResultsThere was no statistic difference in the length of operation(198.33±66.14min vs 196.96±47.42 min,t=0.90,P=0.93),intraoperative blood loss(323.33±288.49ml vs 286.78±296.02 ml,t=-1.06,P=0.29),intraoperative blood transfusion(457.14±97.59ml vs 600±282.84 ml,t=-0.78,P=0.44) incidence of perioperative complication (30.00% vs 17.86%,X2=0.60, P=0.44,pancreatic fistula(16.67% vs 10.71%,X2=0.08,P=0.78),pneumonia(10.00% vs 7.10%:X2=0,P=1.00) in group A and group B. The postoperative length of hospital stay in Group B(13.61±4.45d) was significantly less than that in Group A(16.93±5.95d)(t=-3.07,P=0.002). The length of operation in Group B1(210.25±41.37min) was significantly more than that in Group B2(168.75±46.81min)(t=-2.23,P=0.03).There was no statistic difference in the intraoperative blood loss(278.57±187.46 ml vs 311.49±525.59ml,t=-1.79,P=0.07),intraoperative blood transfusion(500±200 ml vs 1000ml,t=-1.58,P=0.11) incidence of perioperative complication (15% vs 25%,X2=0.06,P=0.94),pancreatic fistula(10% vs 12.5%,X2=0,P=1.00),pneumonia(5.00%vs12.50%,X2=0,P=1.00),postoperrative length of hospital stay(14.3±4.93d vs 11.88±2.36d,t=-1.49,P=0.14)in the two groups.ConclusionThe authors came to the conclusion that SPDP of the benign lesions of the pancreas is feasible, less complication, shorter postoperrative length of hospital stay. There was no statistic difference in incidence of perioperative complication and postoperrative length of hospital stay between B1 and B2 subgroup.