Abstract
BackgroundThe clinical outcomes of patients who received distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) have been generally investigated. However, postoperative hematological changes after distal pancreatectomy with or without splenectomy are poorly understood.MethodsInformation from patients undergoing distal pancreatectomy (DP) between January 2014 and June 2019 at a single institution was reviewed. A linear mixed-effects model was used to compare dynamic hematological changes between different groups.ResultsA total of 302 patients who underwent DP were enrolled. In the long term, most postoperative hematological parameters remained significantly higher than preoperative levels in the DPS group, while postoperative lymphocyte, monocyte, basophil, and platelet levels returned to preoperative levels in the SPDP group. All postoperative hematological parameters except for red blood cell count and serum hemoglobulin level were significantly higher in the DPS group than in the SPDP group. There were no significant differences in hematological changes between the splenic vessel preservation (SVP) and Warshaw technique (WT) groups.ConclusionsPostoperative hematological changes were significantly different between the DPS and SPDP groups. Compared to DPS, SPDP reduced abnormal hematological changes caused by splenectomy. SVP and WT were comparable in terms of postoperative hematological changes.
Highlights
The clinical outcomes of patients who received distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) have been generally investigated
Many pancreatic surgeons further compared the clinical outcomes between patients who received distal pancreatectomy with splenectomy (DPS) and SPDP, and the results showed that the SPDP group may present fewer infection complications, less operative blood loss, and a lower overall morbidity rate [9, 10]
The results showed that postoperative hematological changes in all nine parameters of peripheral blood populations had no significant differences between the splenic vessel preservation (SVP) group
Summary
The clinical outcomes of patients who received distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) have been generally investigated. Many pancreatic surgeons further compared the clinical outcomes between patients who received distal pancreatectomy with splenectomy (DPS) and SPDP, and the results showed that the SPDP group may present fewer infection complications, less operative blood loss, and a lower overall morbidity rate [9, 10]. To understand the mechanisms of the above aberrations, several studies have examined hematologic and immunological changes after splenectomy, presenting thrombocytosis, leukocytosis, decreased immunoglobulin M production, and depressed phagocytic activity [11,12,13,14] The majority of these studies, were based on patients with existing hematological diseases or severe trauma, probably with selection bias as a result of the influences of hematological disorders, massive blood loss on peripheral hematological system, or surgery itself. Exploring the above dynamic changes might be helpful to further understand the pathophysiological processes after DP with or without splenectomy
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