Document Detail


Spleen-preserving distal pancreatectomy with excision of splenic artery and vein: a case-matched comparison with conventional distal pancreatectomy with splenectomy.
MedLine Citation:
PMID:  17171488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The value of spleen preservation during distal pancreatectomy (DP) still remains controversial. Spleen-preserving DP with excision of the splenic artery and vein is a simplified technique for spleen preservation. The aim of this study was to compare the postoperative course of DP with or without splenectomy. PATIENTS AND METHODS: From 1990 to 2005, 38 consecutive patients with benign or low-grade malignant disease underwent a spleen-preserving DP operation with excision of the splenic artery and vein (Conservative Group). They were compared with 38 patients who underwent conventional DP with splenectomy over the same time period (Splenectomy Group) and who had been matched for age, American Society of Anesthesiologists (ASA) score, and pathological diagnosis. Postoperative courses were analyzed and compared between the Conservative Group and Splenectomy Group. RESULTS: Spleen preservation was effective in 36 of the 38 attempts (95%). Postoperative complications - in particular, infectious intra-abdominal complications - were significantly higher in the Splenectomy Group (34 and 18%, respectively) than in the Conservative Group (13 and 3%, respectively) (P = 0.03 and P = 0.02, respectively). The length of the surgery, perioperative blood loss or transfusions, perioperative mortality and length of hospital stay did not differ between the two groups. Univariate analysis showed that splenectomy was the only risk factor for postoperative complication. CONCLUSIONS: Spleen-preserving DP with excision of the splenic artery and vein is a fast, safe and effective procedure associated, in this series, with a reduction of postoperative complications relative to conventional DP with splenectomy. This technique should be considered in patients with benign or low-grade malignant disease of the pancreas.
Authors:
Nicolas Carrère; Skander Abid; Charles Henri Julio; Eric Bloom; Bernard Pradère
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-06-05     Revised Date:  2007-10-12    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-82     Citation Subset:  IM    
Affiliation:
Department of Digestive Surgery (Pr Pradère), Purpan University Hospital, Toulouse, France. carrere.n@chu-toulouse.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Length of Stay
Male
Middle Aged
Pancreatectomy / adverse effects,  methods*
Pancreatic Neoplasms / pathology,  surgery*
Retrospective Studies
Splenectomy*
Splenic Artery / surgery*
Splenic Vein / surgery*
Treatment Outcome
Comments/Corrections
Comment In:
World J Surg. 2007 Jul;31(7):1530; author reply 1531   [PMID:  17487525 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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