Lee SY, Goh BK, Tan YM, Chung YF, Cheow PC, Chow PK, Wong WK, Ooi LL
Correspondence: Dr Tan Yu Meng, gsutym@sgh.com.sg
ABSTRACT
Introduction Splenectomy is routinely performed in conventional distal pancreatectomies. Spleen removal with its possible sequelae of infections and haematological complications has prompted the development of spleen-preserving techniques. This study aimed to evaluate the safety and clinical outcomes of distal pancreatectomy with preservation of the spleen.
Methods A retrospective review of 24 consecutive patients who underwent spleen-preserving distal pancreatectomy in a tertiary care hospital was conducted.
Results There were 17 female and seven male patients, and the mean age was 47 (range 14–77) years. Median American Society of Anesthesiologists score was II (range I–III). The indications were as follows: mucinous cystadenoma (n = 7), serous cystadenoma (n = 6), insulinoma (n = 3), intraductal papillary mucinous tumour (n = 2), pseudocyst (n = 3), papillary cystic adenoma (n = 1), neuroendocrine neoplasm (n = 1), and metastatic carcinoma of the thyroid (n = 1). Two patients developed postoperative pancreatic fistula and another two patients developed postoperative ileus with spontaneous resolution. Mean operative time was 172 (range 105–250) minutes. Mean length of postoperative hospital stay was 6.7 (range 5–11) days. There was no perioperative mortality in this series.
Conclusion Spleen-preserving distal pancreatectomy can be safely performed with low morbidity, and should be considered in the surgical management of distal pancreatic disease.
Keywords: distal pancreatectomy, pancreatec-tomy, spleen-preserving distal pancreatectomy
Singapore Med J 2008; 49(11): 883-885
