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Splenic preservation versus splenectomy in laparoscopic distal pancreatectomy: a propensity score-matched study

Lookup NU author(s): Steven White



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2019, The Author(s). Background: The laparoscopic approach in distal pancreatectomy is associated with higher rates of splenic preservation compared to open surgery. Although favorable postoperative short-term outcomes have been reported in open spleen-preserving distal pancreatectomy when compared to distal pancreatectomy with splenectomy, it is unclear whether this observation applies to the laparoscopic approach. The aim of this study is to compare laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with laparoscopic distal pancreatectomy with splenectomy (LDPS). Study design: This is a UK wide, propensity score-matched study, including patients who underwent LSPDP or LDPS between 2006 and 2016. Short-term outcomes were compared between LSPDP and LDPS according to intention to treat. Additionally, risk factors for unplanned splenectomy were explored. Results: A total of 456 patients were included from eleven centers (229 LSPDP and 227 LDPS). We were able to match 173 LSPDP cases to 173 LDPS cases, according to intention to treat. No differences were seen in postoperative morbidity between the groups. The only identified risk factor for unplanned splenectomy was tumor size ≥ 30 mm. Conclusions: Preserving the spleen during laparoscopic distal pancreatectomy is not associated with a lower postoperative morbidity compared to sacrificing the spleen. Tumor size is a risk factor for unplanned splenectomy.

Publication metadata

Author(s): Moekotte AL, Lof S, White SA, Marudanayagam R, Al-Sarireh B, Rahman S, Soonawalla Z, Deakin M, Aroori S, Ammori B, Gomez D, Marangoni G, Abu Hilal M

Publication type: Article

Publication status: Published

Journal: Surgical Endoscopy

Year: 2019

Pages: Epub ahead of print

Online publication date: 24/06/2019

Acceptance date: 06/06/2019

Date deposited: 15/07/2019

ISSN (print): 0930-2794

ISSN (electronic): 1432-2218

Publisher: Springer


DOI: 10.1007/s00464-019-06901-z


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