Minimally invasive preservation versus splenectomy during distal pancreatectomy

a systematic review and meta-analysis

Kohei Nakata, Satoru Shikata, Ohtsuka Takao, Tomohiko Ukai, Yoshihiro Miyasaka, Yasuhisa Mori, Vittoria Vanessa D.M. Velasquez, Yoshitaka Gotoh, Daisuke Ban, Yoshiharu Nakamura, Yuichi Nagakawa, Minoru Tanabe, Yatsuka Sahara, Kyoichi Takaori, Goro Honda, Takeyuki Misawa, Manabu Kawai, Hiroki Yamaue, Takanori Morikawa, Tamotsu Kuroki & 13 others Yiping Mou, Woo Jung Lee, Shailesh V. Shrikhande, Chung Ngai Tang, Claudius Conrad, Ho Seong Han, Palanivelu Chinnusamy, Horacio J. Asbun, David A. Kooby, Go Wakabayashi, Tadahiro Takada, Masakazu Yamamoto, Masafumi Nakamura

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Minimally invasive distal pancreatectomy (MIDP) has gained in popularity recently. However, there is no consensus on whether to preserve the spleen or not. In this study, we compared MIDP outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS); as well as outcomes between splenic vessel preservation (SVP) and Warshaw's technique (WT). Methods: A systematic search of PubMed (MEDLINE) and Cochrane Library was conducted and the reference lists of review articles were hand-searched. Results: Fifteen relevant studies with 769 patients were selected for meta-analyses of DPS and SPDP, while another 15 studies with 841 patients were used for the analysis between SVP and WT. Compared with the DPS group, SPDP patients had significantly lower incidences of infectious complications (P = 0.006) and pancreatic fistula (P = 0.002), shorter operative time (P < 0.001), and less blood loss (P = 0.01). Compared with WT, SVP patients had significantly lower incidences of splenic infarction (P < 0.001) and secondary splenectomy (P = 0.003). Subanalysis for laparoscopic surgery alone had similar results. Conclusions: Based on this study, SPDP has significantly superior outcomes compared to DPS. When a spleen is preserved, SVP has better outcomes over WT for reducing splenic complications.

Original languageEnglish
Pages (from-to)476-488
Number of pages13
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume25
Issue number11
DOIs
Publication statusPublished - Nov 1 2018

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Pancreatectomy
Splenectomy
Meta-Analysis
Spleen
Splenic Infarction
Pancreatic Fistula
Incidence
Operative Time
PubMed
MEDLINE
Laparoscopy
Libraries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

Cite this

Minimally invasive preservation versus splenectomy during distal pancreatectomy : a systematic review and meta-analysis. / Nakata, Kohei; Shikata, Satoru; Takao, Ohtsuka; Ukai, Tomohiko; Miyasaka, Yoshihiro; Mori, Yasuhisa; Velasquez, Vittoria Vanessa D.M.; Gotoh, Yoshitaka; Ban, Daisuke; Nakamura, Yoshiharu; Nagakawa, Yuichi; Tanabe, Minoru; Sahara, Yatsuka; Takaori, Kyoichi; Honda, Goro; Misawa, Takeyuki; Kawai, Manabu; Yamaue, Hiroki; Morikawa, Takanori; Kuroki, Tamotsu; Mou, Yiping; Lee, Woo Jung; Shrikhande, Shailesh V.; Tang, Chung Ngai; Conrad, Claudius; Han, Ho Seong; Chinnusamy, Palanivelu; Asbun, Horacio J.; Kooby, David A.; Wakabayashi, Go; Takada, Tadahiro; Yamamoto, Masakazu; Nakamura, Masafumi.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 25, No. 11, 01.11.2018, p. 476-488.

Research output: Contribution to journalArticle

Nakata, K, Shikata, S, Takao, O, Ukai, T, Miyasaka, Y, Mori, Y, Velasquez, VVDM, Gotoh, Y, Ban, D, Nakamura, Y, Nagakawa, Y, Tanabe, M, Sahara, Y, Takaori, K, Honda, G, Misawa, T, Kawai, M, Yamaue, H, Morikawa, T, Kuroki, T, Mou, Y, Lee, WJ, Shrikhande, SV, Tang, CN, Conrad, C, Han, HS, Chinnusamy, P, Asbun, HJ, Kooby, DA, Wakabayashi, G, Takada, T, Yamamoto, M & Nakamura, M 2018, 'Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta-analysis', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 25, no. 11, pp. 476-488. https://doi.org/10.1002/jhbp.569
Nakata, Kohei ; Shikata, Satoru ; Takao, Ohtsuka ; Ukai, Tomohiko ; Miyasaka, Yoshihiro ; Mori, Yasuhisa ; Velasquez, Vittoria Vanessa D.M. ; Gotoh, Yoshitaka ; Ban, Daisuke ; Nakamura, Yoshiharu ; Nagakawa, Yuichi ; Tanabe, Minoru ; Sahara, Yatsuka ; Takaori, Kyoichi ; Honda, Goro ; Misawa, Takeyuki ; Kawai, Manabu ; Yamaue, Hiroki ; Morikawa, Takanori ; Kuroki, Tamotsu ; Mou, Yiping ; Lee, Woo Jung ; Shrikhande, Shailesh V. ; Tang, Chung Ngai ; Conrad, Claudius ; Han, Ho Seong ; Chinnusamy, Palanivelu ; Asbun, Horacio J. ; Kooby, David A. ; Wakabayashi, Go ; Takada, Tadahiro ; Yamamoto, Masakazu ; Nakamura, Masafumi. / Minimally invasive preservation versus splenectomy during distal pancreatectomy : a systematic review and meta-analysis. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2018 ; Vol. 25, No. 11. pp. 476-488.
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abstract = "Background: Minimally invasive distal pancreatectomy (MIDP) has gained in popularity recently. However, there is no consensus on whether to preserve the spleen or not. In this study, we compared MIDP outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS); as well as outcomes between splenic vessel preservation (SVP) and Warshaw's technique (WT). Methods: A systematic search of PubMed (MEDLINE) and Cochrane Library was conducted and the reference lists of review articles were hand-searched. Results: Fifteen relevant studies with 769 patients were selected for meta-analyses of DPS and SPDP, while another 15 studies with 841 patients were used for the analysis between SVP and WT. Compared with the DPS group, SPDP patients had significantly lower incidences of infectious complications (P = 0.006) and pancreatic fistula (P = 0.002), shorter operative time (P < 0.001), and less blood loss (P = 0.01). Compared with WT, SVP patients had significantly lower incidences of splenic infarction (P < 0.001) and secondary splenectomy (P = 0.003). Subanalysis for laparoscopic surgery alone had similar results. Conclusions: Based on this study, SPDP has significantly superior outcomes compared to DPS. When a spleen is preserved, SVP has better outcomes over WT for reducing splenic complications.",
author = "Kohei Nakata and Satoru Shikata and Ohtsuka Takao and Tomohiko Ukai and Yoshihiro Miyasaka and Yasuhisa Mori and Velasquez, {Vittoria Vanessa D.M.} and Yoshitaka Gotoh and Daisuke Ban and Yoshiharu Nakamura and Yuichi Nagakawa and Minoru Tanabe and Yatsuka Sahara and Kyoichi Takaori and Goro Honda and Takeyuki Misawa and Manabu Kawai and Hiroki Yamaue and Takanori Morikawa and Tamotsu Kuroki and Yiping Mou and Lee, {Woo Jung} and Shrikhande, {Shailesh V.} and Tang, {Chung Ngai} and Claudius Conrad and Han, {Ho Seong} and Palanivelu Chinnusamy and Asbun, {Horacio J.} and Kooby, {David A.} and Go Wakabayashi and Tadahiro Takada and Masakazu Yamamoto and Masafumi Nakamura",
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T1 - Minimally invasive preservation versus splenectomy during distal pancreatectomy

T2 - a systematic review and meta-analysis

AU - Nakata, Kohei

AU - Shikata, Satoru

AU - Takao, Ohtsuka

AU - Ukai, Tomohiko

AU - Miyasaka, Yoshihiro

AU - Mori, Yasuhisa

AU - Velasquez, Vittoria Vanessa D.M.

AU - Gotoh, Yoshitaka

AU - Ban, Daisuke

AU - Nakamura, Yoshiharu

AU - Nagakawa, Yuichi

AU - Tanabe, Minoru

AU - Sahara, Yatsuka

AU - Takaori, Kyoichi

AU - Honda, Goro

AU - Misawa, Takeyuki

AU - Kawai, Manabu

AU - Yamaue, Hiroki

AU - Morikawa, Takanori

AU - Kuroki, Tamotsu

AU - Mou, Yiping

AU - Lee, Woo Jung

AU - Shrikhande, Shailesh V.

AU - Tang, Chung Ngai

AU - Conrad, Claudius

AU - Han, Ho Seong

AU - Chinnusamy, Palanivelu

AU - Asbun, Horacio J.

AU - Kooby, David A.

AU - Wakabayashi, Go

AU - Takada, Tadahiro

AU - Yamamoto, Masakazu

AU - Nakamura, Masafumi

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Minimally invasive distal pancreatectomy (MIDP) has gained in popularity recently. However, there is no consensus on whether to preserve the spleen or not. In this study, we compared MIDP outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS); as well as outcomes between splenic vessel preservation (SVP) and Warshaw's technique (WT). Methods: A systematic search of PubMed (MEDLINE) and Cochrane Library was conducted and the reference lists of review articles were hand-searched. Results: Fifteen relevant studies with 769 patients were selected for meta-analyses of DPS and SPDP, while another 15 studies with 841 patients were used for the analysis between SVP and WT. Compared with the DPS group, SPDP patients had significantly lower incidences of infectious complications (P = 0.006) and pancreatic fistula (P = 0.002), shorter operative time (P < 0.001), and less blood loss (P = 0.01). Compared with WT, SVP patients had significantly lower incidences of splenic infarction (P < 0.001) and secondary splenectomy (P = 0.003). Subanalysis for laparoscopic surgery alone had similar results. Conclusions: Based on this study, SPDP has significantly superior outcomes compared to DPS. When a spleen is preserved, SVP has better outcomes over WT for reducing splenic complications.

AB - Background: Minimally invasive distal pancreatectomy (MIDP) has gained in popularity recently. However, there is no consensus on whether to preserve the spleen or not. In this study, we compared MIDP outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS); as well as outcomes between splenic vessel preservation (SVP) and Warshaw's technique (WT). Methods: A systematic search of PubMed (MEDLINE) and Cochrane Library was conducted and the reference lists of review articles were hand-searched. Results: Fifteen relevant studies with 769 patients were selected for meta-analyses of DPS and SPDP, while another 15 studies with 841 patients were used for the analysis between SVP and WT. Compared with the DPS group, SPDP patients had significantly lower incidences of infectious complications (P = 0.006) and pancreatic fistula (P = 0.002), shorter operative time (P < 0.001), and less blood loss (P = 0.01). Compared with WT, SVP patients had significantly lower incidences of splenic infarction (P < 0.001) and secondary splenectomy (P = 0.003). Subanalysis for laparoscopic surgery alone had similar results. Conclusions: Based on this study, SPDP has significantly superior outcomes compared to DPS. When a spleen is preserved, SVP has better outcomes over WT for reducing splenic complications.

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