Spleen Preservation in Laparoscopic Distal Pancreatectomy for Solid Pseudopapillary Neoplasm is Oncologically Safe
10.7602/jmis.2019.22.1.18
- Author:
Yongjoon WON
1
;
Yoo Seok YOON
;
Ho Seong HAN
;
Jai Young CHO
;
YoungRok CHOI
;
In Gun HYUN
;
Kil Hwan KIM
Author Information
1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. yoonys@snubh.org
- Publication Type:Original Article
- Keywords:
Laparoscopic distal pancreatectomy;
Spleen preservation;
Solid pseudopapillary neoplasm
- MeSH:
Follow-Up Studies;
Humans;
Incidence;
Medical Records;
Mortality;
Pancreas;
Pancreatectomy;
Pancreatic Fistula;
Postoperative Complications;
Recurrence;
Retrospective Studies;
Spleen;
Splenectomy;
Tail
- From:Journal of Minimally Invasive Surgery
2019;22(1):18-22
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Laparoscopic distal pancreatectomy (LDP) has been widely performed for solid pseudopapillary neoplasm (SPN) involving the body or tail of the pancreas. However, it has not been established whether spleen preservation in LDP is oncologically safe for the treatment of SPN with malignant potential. In this study, we compared the short- and long-term outcomes between patients with SPN who underwent laparoscopic spleen-preserving distal pancreatectomy (LSPDP) vs laparoscopic distal pancreatectomy with splenectomy (LDPS). METHODS: We retrospectively reviewed the medical records of 46 patients with SPN who underwent LDP between January 2005 and November 2016. Patients were divided into 2 groups according to spleen preservation: the LSPDP group (n=32) and the LDPS group (n=14). Clinicopathologic characteristics and perioperative outcomes were compared between groups. RESULTS: There were no significant differences in pathologic variables, including tumor size, tumor location, node status, angiolymphatic invasion, or perineural invasion between groups. Median operating time was significantly longer in the LSPDP group vs the LDPS group (243 vs 172 minutes; p=0.006). Estimated intraoperative blood loss was also significantly greater in the LSPDP group (310 vs 167 ml; p=0.063). There were no significant differences in incidence of postoperative complications (≥ Clavien-Dindo class IIIa) or pancreatic fistula between groups. After a median follow-up of 35 months (range, 3S153 months), there was no recurrence or disease-specific mortality in either group. CONCLUSION: The results show that LSPDP is an oncologically safe procedure for SPN involving the body or tail of the pancreas.
