The spleen may be preserved during distal
pancreatectomy (DP) for benign disease. The aim of this study was to compare the perioperative and postoperative courses of patients with conventional DP and spleen-preserving distal
pancreatectomy (
SPDP) for benign lesions or
tumors with low-grade malignant potential occurred at the body or tail of the pancreas. A retrospective analysis was performed for the hospital records of all the patients undergoing DP and
SPDP between January 1995 and April 2006. One-hundred forty-three patients underwent DP and 37 patients underwent
SPDP. There were no significant differences in age, sex, indications of operation, estimated blood loss,
operative time, and postoperative
hospital stay between the two groups.
Pancreatic fistula occurred in 21 (13.3%) patients following DP and in 3 (8.1%) following
SPDP without a significant difference (p=0.081). Portal vein
thrombosis occurred in 4 patients after DP.
Splenic infarction occurred in one patient after
SPDP. Overwhelming postosplenectomy
infection was observed in one patient after DP.
SPDP can be achieved with no increase in complication rate,
operative time, or length of postoperative hospitalization as compared to conventional DP. Additionally, it has the advantage of reducing the risk of overwhelming postsplenectomy
infection and postoperative
venous thrombosis.