Comparison Of Laparoscopic Versus Open Spleen-preserving Distal Pancreatectomy

OBJECTIVES: The aim of this study was to evaluate the safety, feasibility of laparoscopic spleen-preserving distal pancreatectomy(LSPDP). The short-term clinical outcomes of LSPDP was compared with that of open spleen-preserving distal pancreatectomy(OSPDP) in patients suffering pancreas body or tail benign diseases.METHODS: From Dec. 2010 to Apr. 2016, 37 patients suffering from benign diseases of pancreas body or tail were selected and according to surgical approach they were divided into two groups: LSPDP group(n=21) and OSPDP group(n=16). And the clinical data were compared between the two groups retrospectively.RESULTS: All operations were performed successfully and in LSPDP group no conversions to open were necessary. There were no significant differences between LSPDP group and OSPDP group in the operating time(221 min vs 230 min, P = 0.465), morbidity rate(38.1% vs 50.0%, P = 0.348), pancreatic fistula(28.6% vs 31.5%, P = 0.571), and re-operation rates(0.0% vs 6.25%, P = 0.432). Intro-operative blood loss was significantly decreased in LSPDP group compared with that of OSPDP group(246 mL vs 450 mL, P<0.01), intensive care unit stay(9.5% vs 31.3%, P<0.05), first flatus time(1.2 d vs 2.5 d, P<0.05), diet start time(2.6 d vs 3.9 d, P<0.05), postoperative hospital stay(7.4 d vs 13.4 d, P<0.05) and delayed gastric emptying rate(0.0% vs 18.75%, P<0.05). And there were no significant differences in splenic infarction(0.0% vs 6.25%, P = 0.432) between the two groups.CONCLUSION: LSPDP has the advantages of shorter hospital stay and faster postoperative recovery compared with OSPDP. It may be a safe and feasible option for patients with lesions in the body and tail of the pancreas.