The value of splenic preservation with distal pancreatectomy

Margo Shoup, Murray F. Brennan, Kertrisa McWhite, Denis H Y Leung, David Klimstra, Kevin C. Conlon*

*Corresponding author for this work

Research output: Contribution to journalArticle

263 Scopus citations

Abstract

Hypothesis: Splenic-preserving distal pancreatectomy for benign or low-grade malignant disease is associated with decreased perioperative morbidity compared with conventional distal pancreatectomy with splenectomy. Design: A retrospective review of a prospective database of patients. Setting: Memorial Sloan-Kettering Cancer Center, New York, NY. Patients: All patients (N=211) undergoing distal pancreatectomy. Main Outcome Measures: Perioperative complications, length of postoperative stay, and overall survival times were analyzed. Results: After excluding patients with adenocarcinoma and those who had other major organ resection, 125 patients underwent distal pancreatectomy for benign or low-grade malignant disease with splenectomy (n=79) or splenic preservation (n=46). Perioperative complications occurred in 39 (49%) of the 79 patients following splenectomy and 18 (39%) of the 46 patients following splenic preservation (P=.21). Perioperative infectious complications and severe complications were significantly higher in the splenectomy group (28% and 11%) compared with the splenic preservation group (9% and 2%) (P=.01 and .05), respectively. Length of hospital stay was 9 days (range, 5-41 days) following splenectomy and 7 days (range, 5-26 days) following splenic preservation (P<.01). No difference in length of surgery, units of blood transfused, or perioperative mortality was noted between groups. Conclusions: Splenic preservation following distal pancreatectomy for benign or low-grade malignant disease is safe and is associated with a reduction in perioperative infectious complications, severe complications, and length of hospital stay compared with conventional distal pancreatectomy with splenectomy. Therefore, splenic preservation should be considered in this group of patients.

Original languageEnglish (US)
Pages (from-to)164-168
Number of pages5
JournalArchives of Surgery
Volume137
Issue number2
DOIs
StatePublished - Jan 1 2002

ASJC Scopus subject areas

  • Surgery

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    Shoup, M., Brennan, M. F., McWhite, K., Leung, D. H. Y., Klimstra, D., & Conlon, K. C. (2002). The value of splenic preservation with distal pancreatectomy. Archives of Surgery, 137(2), 164-168. https://doi.org/10.1001/archsurg.137.2.164