Laparoscopic distal pancreatectomy: analysis of trends in surgical techniques, patient selection, and outcomes

Abstract

This analysis did not identify parameters related to the patient selection process and the learning curve in LDP. The incidence of new-onset diabetes was lower than reported in other series. The possibility of serious infections following splenectomy has to be taken into account, such that a strict adherence to vaccine protocols is strongly recommended.

Distal pancreatectomy for benign and low grade malignant tumors: Short‐term postoperative outcomes of spleen preservation—A systematic review and update meta‐analysis

“…Reports on immunizations against encapsulated bacteria such as pneumococcus, haemophilus influenza type B, and meningococcus suggest that vaccination after splenectomy is far from systematic. This concept is consistent with the findings obtained by Giuseppe Malleo [44], where only 1 out of 29 patients who had splenectomy, subsequently developed OPSI 11 years after the operation and that patient recovered. In that study, secondary thrombocytosis have also been discussed as a possible adverse outcome after splenectomy, occurring in 23 out of 29 patients, of these 19 were given acetylsalicylic acid for thrombosis prevention.…”

Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta‐analysis

“…The search strategy yielded 411 articles and we checked the title and abstract of the studies according to the inclusion and exclusion criteria and selected 53 articles. After the full texts of the remaining articles were read, 15 articles were included in the meta-analysis of MI-SPDP versus MI-DPS [13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] and 15 articles were included in the meta-analysis of MI-SVP versus MI-WT [13,23,[31][32][33][34][35][36][37][38][39][40][41][42][43]. Figure 1 shows the flow diagram of study identification and evaluation during the review process.…”

“…In the LWT group, 48 (24.9%) of 193 patients showed splenic infarction (symptomatic or asymptomatic). Meta-analysis showed the ratio of splenic infarction was [13,19,20,22,29] significantly lower in the LSVP group compared with in the LWT group (OR 0.14; 95% CI: 0.08, 0.26), and there was no heterogeneity between the trials (P = 0.97;…”

Laparoscopic spleen-preserving distal pancreatectomy for a solid-cystic intraabdominal desmoid tumor at a gastro-pancreatic lesion: a case report

“…We chose distal pancreatectomy to avoid the risk of histologically incomplete resection by the extirpation of the tumor. SPDP is beneficial for patients, because it can prevent an increased risk of overwhelming postsplenectomy infection by preserving the splenic immunological function [15]. Laparoscopic surgery is desirable not only because it is minimally invasive, but also because it favors spleen preservation due to a magnified laparoscopic view, which allows for safe dissection of the small pancreatic vessels [16].…”