Distal pancreatectomy for benign and low grade malignant tumors

Short-term postoperative outcomes of spleen preservation—A systematic review and update meta-analysis

Fiorella Pendola, Rahul Gadde, Caroline Ripat, Rishika Sharma, Omar Picado, Laila Lobo, Danny Sleeman, Alan S. Livingstone, Nipun Merchant, Danny Yakoub

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). Methods: Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included. Results: Meta-analysis of included data showed SPDP patients had significantly less operative blood loss, shorter duration of hospitalization, lower incidence of fluid collection and abscess, lower incidence of postoperative splenic and portal vein thrombosis, and lower incidence of new onset postoperative diabetes. For the whole group, there was no difference in incidence of postoperative pancreatic fistula (POPF) (RR = 0.95; 95%CI 0.65–1.40, P = 0.80), however, subgroup analysis of studies using ISGPF criteria showed that DPS patients had increased rates of Grade B/C POPF (RR = 1.35; 95%CI 1.08–1.70, P = 0.01). Conclusions: SPDP for benign and low grade malignant tumors is associated with shorter hospital stay and decreased morbidity compared to DPS. J. Surg. Oncol. 2017;115:137–143.

Original languageEnglish (US)
Pages (from-to)137-143
Number of pages7
JournalJournal of Surgical Oncology
Volume115
Issue number2
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

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Pancreatectomy
Splenectomy
Meta-Analysis
Spleen
Pancreatic Fistula
Incidence
Neoplasms
Splenic Vein
Bibliography
Portal Vein
Abscess
Length of Stay
Hospitalization
Thrombosis
Databases
Morbidity
N-succinimidyl 3-(2-pyridyldithio)propionate

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Distal pancreatectomy for benign and low grade malignant tumors : Short-term postoperative outcomes of spleen preservation—A systematic review and update meta-analysis. / Pendola, Fiorella; Gadde, Rahul; Ripat, Caroline; Sharma, Rishika; Picado, Omar; Lobo, Laila; Sleeman, Danny; Livingstone, Alan S.; Merchant, Nipun; Yakoub, Danny.

In: Journal of Surgical Oncology, Vol. 115, No. 2, 01.02.2017, p. 137-143.

Research output: Contribution to journalArticle

Pendola, Fiorella ; Gadde, Rahul ; Ripat, Caroline ; Sharma, Rishika ; Picado, Omar ; Lobo, Laila ; Sleeman, Danny ; Livingstone, Alan S. ; Merchant, Nipun ; Yakoub, Danny. / Distal pancreatectomy for benign and low grade malignant tumors : Short-term postoperative outcomes of spleen preservation—A systematic review and update meta-analysis. In: Journal of Surgical Oncology. 2017 ; Vol. 115, No. 2. pp. 137-143.
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abstract = "Background: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). Methods: Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included. Results: Meta-analysis of included data showed SPDP patients had significantly less operative blood loss, shorter duration of hospitalization, lower incidence of fluid collection and abscess, lower incidence of postoperative splenic and portal vein thrombosis, and lower incidence of new onset postoperative diabetes. For the whole group, there was no difference in incidence of postoperative pancreatic fistula (POPF) (RR = 0.95; 95{\%}CI 0.65–1.40, P = 0.80), however, subgroup analysis of studies using ISGPF criteria showed that DPS patients had increased rates of Grade B/C POPF (RR = 1.35; 95{\%}CI 1.08–1.70, P = 0.01). Conclusions: SPDP for benign and low grade malignant tumors is associated with shorter hospital stay and decreased morbidity compared to DPS. J. Surg. Oncol. 2017;115:137–143.",
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