TY - JOUR
T1 - Distal pancreatectomy for benign and low grade malignant tumors
T2 - Short-term postoperative outcomes of spleen preservation—A systematic review and update meta-analysis
AU - Pendola, Fiorella
AU - Gadde, Rahul
AU - Ripat, Caroline
AU - Sharma, Rishika
AU - Picado, Omar
AU - Lobo, Laila
AU - Sleeman, Danny
AU - Livingstone, Alan S.
AU - Merchant, Nipun
AU - Yakoub, Danny
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). Methods: Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included. Results: Meta-analysis of included data showed SPDP patients had significantly less operative blood loss, shorter duration of hospitalization, lower incidence of fluid collection and abscess, lower incidence of postoperative splenic and portal vein thrombosis, and lower incidence of new onset postoperative diabetes. For the whole group, there was no difference in incidence of postoperative pancreatic fistula (POPF) (RR = 0.95; 95%CI 0.65–1.40, P = 0.80), however, subgroup analysis of studies using ISGPF criteria showed that DPS patients had increased rates of Grade B/C POPF (RR = 1.35; 95%CI 1.08–1.70, P = 0.01). Conclusions: SPDP for benign and low grade malignant tumors is associated with shorter hospital stay and decreased morbidity compared to DPS. J. Surg. Oncol. 2017;115:137–143.
AB - Background: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). Methods: Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included. Results: Meta-analysis of included data showed SPDP patients had significantly less operative blood loss, shorter duration of hospitalization, lower incidence of fluid collection and abscess, lower incidence of postoperative splenic and portal vein thrombosis, and lower incidence of new onset postoperative diabetes. For the whole group, there was no difference in incidence of postoperative pancreatic fistula (POPF) (RR = 0.95; 95%CI 0.65–1.40, P = 0.80), however, subgroup analysis of studies using ISGPF criteria showed that DPS patients had increased rates of Grade B/C POPF (RR = 1.35; 95%CI 1.08–1.70, P = 0.01). Conclusions: SPDP for benign and low grade malignant tumors is associated with shorter hospital stay and decreased morbidity compared to DPS. J. Surg. Oncol. 2017;115:137–143.
KW - distal pancreatectomy
KW - postoperative pancreatic fistula
KW - spleen preserving distal pancreatectomy
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U2 - 10.1002/jso.24507
DO - 10.1002/jso.24507
M3 - Article
C2 - 28133818
AN - SCOPUS:85010850327
SN - 0022-4790
VL - 115
SP - 137
EP - 143
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 2
ER -