LAPAROSCOPIC DISTAL PANCREATECTOMY WITH OR WITHOUT SPLEEN PRESERVATION: COMPARATIVE ANALYSIS OF SHORT AND LONG-TERM...

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Laparoscopic distal pancreatectomy (LDP) is the preferred surgical approach for distal pancreatic tumors.
• Advantages of LDP over open surgery include faster recovery and reduced morbidity.
• Tumor location in the distal pancreas necessitates careful consideration of surgical technique.

Purpose of the Study:

• To compare short- and long-term outcomes of LDP with splenectomy versus spleen preservation.
• To evaluate the impact of splenic preservation on patient recovery and complications.
• To determine the optimal LDP technique based on oncological and functional outcomes.

Main Methods:

• A retrospective study of 58 patients undergoing LDP.
• Patients were divided into two groups: LDP with splenectomy (LDPS) and LDP with spleen preservation (LDPSPPSV).
• Outcomes analyzed included operative time, blood loss, lymph node yield, conversion rates, morbidity, mortality, hospital stay, and long-term complications.

Main Results:

• LDPS had significantly higher operative times, intra-operative blood loss, and lymph node yield compared to LDPSPPSV.
• No significant differences were observed in open conversion rates, morbidity, early postoperative mortality, hospital stay, pancreatic fistula rates, or late complications.
• Follow-up averaged 37.6 months, with no spleen-related infections or neoplasms noted in either group.

Conclusions:

• Both LDP techniques are comparable, but LDPS involves greater blood loss and operative time.
• Spleen preservation in LDP avoids the need for post-splenectomy immunizations.
• LDP with spleen preservation is indicated for small pancreatic lesions with an indolent clinical course.