TY - JOUR
T1 - Minimally invasive preservation versus splenectomy during distal pancreatectomy
T2 - a systematic review and meta-analysis
AU - Nakata, Kohei
AU - Shikata, Satoru
AU - Ohtsuka, Takao
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
Y1 - 2018/11
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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U2 - 10.1002/jhbp.569
DO - 10.1002/jhbp.569
M3 - Article
C2 - 29943909
AN - SCOPUS:85052378329
VL - 25
SP - 476
EP - 488
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
IS - 11
ER -