Laparoscopic Spleen-preserving Distal Pancreatectomy With And Without Splenic Vessel Preservation:a Comparative Study

ObjectiveTo compare the clinical efficacy of two procedures of laparoscopic spleen-preserving distal pancreatectomy (LSPDP).MethodsThe clinical data on45patients who had undergone LSPDP with splenic vessel preservation (28patients, SVP group) or with splenic vessel removal (17patients, WT group) from December2004to January2013were retrospectively analyzed. The age, sex, clinical presentations, perioperative parameters, postoperative complications etc. were compared between the two groups.ResultsThe clinical characteristics were similar in both groups, except for tumor size, which was significantly greater in WT group (3.92cm vs.2.59cm, p=0.007). The mean operative time, mean intraoperative blood loss, mean length of postoperative stay did not differ between the two groups. The rate of overall postoperative complication was31.11%(14/28), including24.44%(11/45) of clinical pancreatic fistula. The incidence of overall postoperative complications and pancreatic fistula did not differ significantly. The postoperative pathological diagnosis:19cases of cystadenoma (10serous cystadenoma,9mucinous cystadenoma),13cases of neuroendocrine tumors,7cases of pancreatic solid-pseudopapillary tumors,3cases of pancreatic pseudocyst,1case of intra-pancreatic accessory spleen,1case of acinar cell cystadenoma,1case with unknown pathology.ConclusionsLSPDP is suitable for the distal pancreatic benign or low-grade malignant lesions. Splenic vessel preservation technique can be the first choice method for LSPDP. Under special conditions, splenic vessel removal technique can also be considered.