Detailed Abstract
[BP Poster Presentation 3]
[BP PP 3-1] Should we always preserve spleen in adult patients with benign and low grade malignant pancreatic lesions?
Seung Soo HONG1, Chang Moo KANG*1, 2, Ho Kyoung HWANG1, 2, Woo Jung LEE1, 2, Gun Hee JUNG1, Sung Whan CHA3
1Department of Surgery, Yonsei University College of Medicine, Korea
2Division of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Korea
3Department of Surgery, Yonsei University Wonju College of Medicine, Korea
Introduction : Spleen is the largest immunologic organ, and combined splenectomy is known to be associated with infection-related complications and adverse postoperative outcomes in laparoscopic distal pancreatectomy (LDP). However, most available evidences were published based on early experiences of LDP, which makes it necessary to re-evaluate potential impact of combined splenectomy on postoperative outcome after LDP
Methods : From 2005 to 2015, medical records of the patients who underwent LDP were retrospectively review. Comparative analysis between spleen-preserving distal pancreatectomy (SpDP) and DPS was performed according to time period. Time period was divided into two group; Era 1 (2005-2010) and Era 2 (2011-2015). Perioperative outcomes including overall complication, postoperative pancreatic fistula (POPF), operation time, length of hospital stay, estimated blood loss, and transfusion were evaluated. In addition, long-term postoperative immunologic profiles, such as Lamda-chain, Kappa-chain, IgA, IgM, and IgG were investigated.
Results : According to time period, there was significant improvement of LOH (p=0.005), EBL (p=0.023), severity of complication (p=0.005) and POPF (p<0.001) after DPS. When comparing between SpDP and DPS, perioperative outcomes were similar between two group (p>0.05). In addition, long-term immunologic profiling was also comparable between SpDP and DPS (p>0.05).
Conclusions : With the advance of laparoscopic techniques and experiences, laparoscopic DPS shows comparable postoperative outcomes to SpDP. Laparoscopic DPS is well standardized surgical techniques and can be performed safely. Potential role of spleen needs to be further investigated in adult patients.
Methods : From 2005 to 2015, medical records of the patients who underwent LDP were retrospectively review. Comparative analysis between spleen-preserving distal pancreatectomy (SpDP) and DPS was performed according to time period. Time period was divided into two group; Era 1 (2005-2010) and Era 2 (2011-2015). Perioperative outcomes including overall complication, postoperative pancreatic fistula (POPF), operation time, length of hospital stay, estimated blood loss, and transfusion were evaluated. In addition, long-term postoperative immunologic profiles, such as Lamda-chain, Kappa-chain, IgA, IgM, and IgG were investigated.
Results : According to time period, there was significant improvement of LOH (p=0.005), EBL (p=0.023), severity of complication (p=0.005) and POPF (p<0.001) after DPS. When comparing between SpDP and DPS, perioperative outcomes were similar between two group (p>0.05). In addition, long-term immunologic profiling was also comparable between SpDP and DPS (p>0.05).
Conclusions : With the advance of laparoscopic techniques and experiences, laparoscopic DPS shows comparable postoperative outcomes to SpDP. Laparoscopic DPS is well standardized surgical techniques and can be performed safely. Potential role of spleen needs to be further investigated in adult patients.
SESSION
BP Poster Presentation 3
E-Session 7/27 ~ 7/29 ALL DAY