Clinical study on splenic infarction after spleen-preserving distal pancreatectomy

Abstract

Objective To compare splenic infarction incidence and clinical outcome of spleen-preserving distal pancreatectomy (SPDP) with splenic vessel preservation (SVP, Kimura procedure) or splenic vessel resection (SVR, Warshaw procedure). Methods We retrospectively reviewed clinical data of 181 patients who underwent SPDP for benign and low-grade malignant tumors occurred in pancreatic body and cauda between January 2007 and December 2013. Cases were divided into SVP (n=146) and SVR (n=35) groups. Safety and postoperative complications were compared to evaluate splenic infarction between the two groups. Results There were no significant differences in operation duration, intraoperative blood loss between the two groups (P>0.05). With CT study performed 3 days after operation, splenic infarction incidence was 15.1% (22/146) in SVP group and 60.0% (21/35) in SVR group, all the patients from two groups recovered within 12 months after operation, which were (3.2±3.0) months and (4.8±3.3) months in SVP and SVR groups, respectively. Conclusions Splenic infarction is the main complication resulted from SPDP with SVP and SVR. Nevertheless, the incidence of postoperative splenic infarction is significantly lower in SVP than SVR. Spleen-preserving distal pancreatectomy with splenic vessel preservation is preferred. Key words: Spleen-preserving; Splenic vessel preservation; Splenic vessel resection; Distal pancreatectomy; Kimura procedure; Warshaw procedure