Comparison of Curative Effect Between Laparoscopic Spleen-Preserving Distal Pancrea-tectomy and Laparoscopic Distal Pancreatectomy with Splenectomy for Occupancy Lesions in Pancreatic Body and Tail_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZOUXiao-ming , ZHANGSheng-bin , SONGShi-peng

Department of General Surgery, The Third Affiliated Hospital of Inner Mongolia Medical University, Baotou 014010, Inner Mongolia Autonomous Region, China;

Corresponding author：

ZOUXiao-ming, Email: 361802817@qq.com

Keywords：

Occupancy lesions in pancreatic body and tail; Laparoscopic spleen-preserving distal pancreatectomy; Laparoscopic distal pancreatectomy with splenectomy; Curative effect

DOI：

10.7507/1007-9424.20150283

Video：

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Objective To explore the security and advantages of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for occupancy lesions in pancreatic body and tail. Methods A total of 97 patients with occupancy lesions in pancreatic body and tail who underwent laparoscopic distal pancreatectomy in our hospital from June 2010 to August 2014 were collected retrospectively, and were divided into LSPDP group (n=60) and laparoscopic distal pancreatectomy with splenectomy (LDPS) group (n=37) according to the surgery, clinical effect was compared between the 2 groups. Results The operations got well in all patients, no one died during perioperative period. The operation time was shorter in LSPDP group than that of LDPS group[(190.83±66.39) min vs. (224.46±83.23) min, P=0.030], but there was no significant difference between LSPDP group and LDPS group in the blood loss[45.35 mL vs. 54.92 mL], hospital stay[(8.38±4.06) d vs. (9.76±4.54) d], incidence of total postoperative complication[23.33% (14/60) vs. 13.51% (5/37)], and degree of postoperative complication (P>0.050). There were 86 patients were followed up for 3-54 months, with the median time of 18 months. For patients with tumor, no one suffered from recurrence, metastasis, and death during the follow-up period, and other patients with benign diseases had an excellent prognosis. Conclusion For occupancy lesions in pancreatic body and tail, LSPDP is feasible and safe.

Citation： ZOUXiao-ming, ZHANGSheng-bin, SONGShi-peng. Comparison of Curative Effect Between Laparoscopic Spleen-Preserving Distal Pancrea-tectomy and Laparoscopic Distal Pancreatectomy with Splenectomy for Occupancy Lesions in Pancreatic Body and Tail. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1091-1095. doi: 10.7507/1007-9424.20150283 Copy

1.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications:a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2):205-213.
2.	Bausch D, Keck T. Minimally invasive pancreatic tumor surgery:oncological safety and surgical feasibility. Chirurg, 2014, 85(8):683-688.
3.	邢宝才, 孙谊, 包全, 等. 保留脾脏和脾血管的胰体尾切除术. 中华医学杂志, 2006, 86(10):690-692.
4.	Hwang HK, Chung YE, Kim KA, et al. Revisiting vascular patency after spleen-preserving laparoscopic distal pancreatectomy with conservation of splenic vessels. Surg Endosc, 2012, 26(6):1765-1771.
5.	王广义, 吕国悦, 刘亚辉, 等. 腹腔镜远端胰腺切除的临床应用. 中华普通外科杂志, 2011, 26(2):127-129.
6.	Ikeda T, Yoshiya S, Toshima T, et al. Laparoscopic distal pancreatec-tomy preserving the spleen and splenic vessels for benign and low-grade malignant pancreatic neoplasm. Fukuoka Igaku Zasshi, 2013, 104(3):54-63.
7.	Fernández-Cruz L, Martínez I, Gilabert R, et al. Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. J Gastrointest Surg, 2004, 8(4):493-501.
8.	Warshaw AL. Conservation of the spleen with distal pancreatec-tomy. Arch Surg, 1988, 123(5):550-553.
9.	Kim SC, Park KT, Hwang JW, et al. Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution. Surg Endosc, 2008, 22(10):2261-2268.
10.	Kimura W, Inoue T, Futakawa N, et al. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. Surgery, 1996, 120(5):885-890.
11.	Choi SH, Seo MA, Hwang HK, et al. Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis. Surg Endosc, 2012, 26(11):3149-3156.
12.	Carrère N, Abid S, Julio CH, et al. Spleen-preserving distal pancrea-tectomy with excision of splenic artery and vein:a case-matched comparison with conventional distal pancreatectomy with splenec-tomy. World J Surg, 2007, 31(2):375-382.
13.	Mekeel KL, Moss AA, Reddy KS, et al. Laparoscopic distal pancrea-tectomy:does splenic preservation affect outcomes?. Surg Laparosc Endosc Percutan Tech, 2011, 21(5):362-365.
14.	Zhao YP, Du X, Dai MH, et al. Laparoscopic distal pancreatectomy with or without splenectomy:spleen-preservation does not increase morbidity. Hepatobiliary Pancreat Dis Int, 2012, 11(5):536-541.
15.	Nau P, Melvin WS, Narula VK, et al. Laparoscopic distal pancreatec-tomy with splenic conservation:an operation without increased morbidity. Gastroenterol Res Pract, 2009, 2009:846340.
16.	Adam JP, Jacquin A, Laurent C, et al. Laparoscopic spleen-preser-ving distal pancreatectomy:splenic vessel preservation compared with the Warshaw technique. JAMA Surg, 2013, 148(3):246-252.
17.	Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition. Surgery, 2005, 138(1):8-13.
18.	Wagner M, Gloor B, Ambühl M, et al. Roux-en-Y drainage of the pancreatic stump decreases pancreatic fistula after distal pancreatic resection. J Gastrointest Surg, 2007, 11(3):303-308.
19.	Vijan SS, Ahmed KA, Harmsen WS, et al. Laparoscopic vs open distal pancreatectomy:a single-institution comparative study. Arch Surg, 2010, 145(7):616-621.
20.	Dinorcia J, Schrope BA, Lee MK, et al. Laparoscopic distal pancrea-tectomy offers shorter hospital stays with fewer complications. J Gastrointest Surg, 2010, 14(11):1804-1812.
21.	Yoon YS, Lee KH, Han HS, et al. Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatec-tomy. Br J Surg, 2009, 96(6):633-640.
22.	Hartwig W, Duckheim M, Strobel O, et al. LigaSure for pancreatic sealing during distal pancreatectomy. World J Surg, 2010, 34(5):1066-1070.
23.	Edwin B, Mala T, Mathisen Ø, et al. Laparoscopic resection of the pancreas:a feasibility study of the short-term outcome. Surg Endosc, 2004, 18(3):407-411.
24.	Park AE, Heniford BT. Therapeutic laparoscopy of the pancreas. Ann Surg, 2002, 236(2):149-158.
25.	Bilimoria MM, Cormier JN, Mun Y, et al. Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg, 2003, 90(2):190-196.
26.	Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH):an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery, 2007, 142(1):20-25.
27.	牟一平, 陈其龙, 徐晓武, 等. 保留脾脏的腹腔镜胰体尾切除术治疗经验. 中华外科杂志, 2006, 44(3):200-201.

1. Dindo D, Demartines N, Clavien PA. Classification of surgical complications:a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2):205-213.
2. Bausch D, Keck T. Minimally invasive pancreatic tumor surgery:oncological safety and surgical feasibility. Chirurg, 2014, 85(8):683-688.
3. 邢宝才, 孙谊, 包全, 等. 保留脾脏和脾血管的胰体尾切除术. 中华医学杂志, 2006, 86(10):690-692.
4. Hwang HK, Chung YE, Kim KA, et al. Revisiting vascular patency after spleen-preserving laparoscopic distal pancreatectomy with conservation of splenic vessels. Surg Endosc, 2012, 26(6):1765-1771.
5. 王广义, 吕国悦, 刘亚辉, 等. 腹腔镜远端胰腺切除的临床应用. 中华普通外科杂志, 2011, 26(2):127-129.
6. Ikeda T, Yoshiya S, Toshima T, et al. Laparoscopic distal pancreatec-tomy preserving the spleen and splenic vessels for benign and low-grade malignant pancreatic neoplasm. Fukuoka Igaku Zasshi, 2013, 104(3):54-63.
7. Fernández-Cruz L, Martínez I, Gilabert R, et al. Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. J Gastrointest Surg, 2004, 8(4):493-501.
8. Warshaw AL. Conservation of the spleen with distal pancreatec-tomy. Arch Surg, 1988, 123(5):550-553.
9. Kim SC, Park KT, Hwang JW, et al. Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution. Surg Endosc, 2008, 22(10):2261-2268.
10. Kimura W, Inoue T, Futakawa N, et al. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. Surgery, 1996, 120(5):885-890.
11. Choi SH, Seo MA, Hwang HK, et al. Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis. Surg Endosc, 2012, 26(11):3149-3156.
12. Carrère N, Abid S, Julio CH, et al. Spleen-preserving distal pancrea-tectomy with excision of splenic artery and vein:a case-matched comparison with conventional distal pancreatectomy with splenec-tomy. World J Surg, 2007, 31(2):375-382.
13. Mekeel KL, Moss AA, Reddy KS, et al. Laparoscopic distal pancrea-tectomy:does splenic preservation affect outcomes?. Surg Laparosc Endosc Percutan Tech, 2011, 21(5):362-365.
14. Zhao YP, Du X, Dai MH, et al. Laparoscopic distal pancreatectomy with or without splenectomy:spleen-preservation does not increase morbidity. Hepatobiliary Pancreat Dis Int, 2012, 11(5):536-541.
15. Nau P, Melvin WS, Narula VK, et al. Laparoscopic distal pancreatec-tomy with splenic conservation:an operation without increased morbidity. Gastroenterol Res Pract, 2009, 2009:846340.
16. Adam JP, Jacquin A, Laurent C, et al. Laparoscopic spleen-preser-ving distal pancreatectomy:splenic vessel preservation compared with the Warshaw technique. JAMA Surg, 2013, 148(3):246-252.
17. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition. Surgery, 2005, 138(1):8-13.
18. Wagner M, Gloor B, Ambühl M, et al. Roux-en-Y drainage of the pancreatic stump decreases pancreatic fistula after distal pancreatic resection. J Gastrointest Surg, 2007, 11(3):303-308.
19. Vijan SS, Ahmed KA, Harmsen WS, et al. Laparoscopic vs open distal pancreatectomy:a single-institution comparative study. Arch Surg, 2010, 145(7):616-621.
20. Dinorcia J, Schrope BA, Lee MK, et al. Laparoscopic distal pancrea-tectomy offers shorter hospital stays with fewer complications. J Gastrointest Surg, 2010, 14(11):1804-1812.
21. Yoon YS, Lee KH, Han HS, et al. Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatec-tomy. Br J Surg, 2009, 96(6):633-640.
22. Hartwig W, Duckheim M, Strobel O, et al. LigaSure for pancreatic sealing during distal pancreatectomy. World J Surg, 2010, 34(5):1066-1070.
23. Edwin B, Mala T, Mathisen Ø, et al. Laparoscopic resection of the pancreas:a feasibility study of the short-term outcome. Surg Endosc, 2004, 18(3):407-411.
24. Park AE, Heniford BT. Therapeutic laparoscopy of the pancreas. Ann Surg, 2002, 236(2):149-158.
25. Bilimoria MM, Cormier JN, Mun Y, et al. Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg, 2003, 90(2):190-196.
26. Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH):an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery, 2007, 142(1):20-25.
27. 牟一平, 陈其龙, 徐晓武, 等. 保留脾脏的腹腔镜胰体尾切除术治疗经验. 中华外科杂志, 2006, 44(3):200-201.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of Curative Effect Between Laparoscopic Spleen-Preserving Distal Pancrea-tectomy and Laparoscopic Distal Pancreatectomy with Splenectomy for Occupancy Lesions in Pancreatic Body and Tail

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