| International Session (Symposium) 4 (JSGS・JSH) |
| Fri. November 2nd 9:40 - 12:00 Room 12: Kobe International Conference Center Main Hall |
| Spleen preservation versus splenectomy during distal pancreatectomy: A systematic review and meta-analysis | |||
| Kohei Nakata1, Takao Ohtsuka1, Masafumi Nakamura1 | |||
| 1Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University | |||
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| Background: Minimally invasive distal pancreatectomy (MIDP) including laparoscopic and robotic techniques, has gained large popularity in recent years. However, the consensus regarding preservation of the spleen remains inconsistent. In this study, we compared MIDP outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). Methods: A systematic search of PubMed (MEDLINE) and Cochrane Library was conducted and the reference lists of review articles were hand-searched. The primary outcomes were the prevalence of infectious complication and abdominal abscess, and overall morbidity. Results: Fifteen relevant studies with 769 patients were selected for meta-analyses of DPS and SPDP. In SPDP patients, the prevalence of infectious complications (odds ratio 0.36; 95%CI 0.17, 0.74; P = 0.006), pancreatic fistula (odds ratio 0.43; 95% CI 0.25, 0.74; P = 0.002), operative time (MD -29,74 min; 95% CI -46.28, -13.21; P < 0.001) and blood loss (MD -83,95 g; 95% CI -151.28, -16.63; P = 0.01) was significantly lower than those in the DPS group. On the other hand, there were no significant difference in the incidence of abdominal abscess between the two groups. Sub-analyses for laparoscopy alone had similar results. Conclusion: Based on this study, SPDP has significantly superior outcomes, compared to DPS. |
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Index Term 1: distal pancreatectomy Index Term 2: spleen preservation |
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