Open vs.laparoscopic spleen-preserving distal pancreatectomy for benign pancreatic lesions / 中华普通外科杂志

ABSTRACT

Objective To compare the clinical results of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and open spleen-preserving distal pancreatectomy (OSPDP).Methods From Jan 2014 to Aug 2017,the clinical results of 30 patients undergoing LSPDP were compared with those of 20 OSPDP patients.The postoperative pancreatic fistula rate was the main observation index.Results There was significant difference in operation time [(140.33 ±55.93) min vs.(182.71 ±43.51)min],blood loss [(175.61 ± 180.78) ml vs.(253.51 ± 176.06) ml],postoperative hospital stay [(6.16 ± 7.22) d vs.(8.85 ± 9.36) d],postoperative exhaust [(2.17 ± 1.43) d vs.(3.10 ± 1.89) d],and postoperative feeding time [(2.26 ± 1.78)d vs.(3.42 ±2.01)d] between LSPDP and OSPDP.LSPDP group was better than OSPDP group (all P ＜ 0.05).The rate of postoperative pancreatic fistula (66.7％ vs.70.0％) and overall complications (80％ vs.90.0％) were not statistically different between the two groups.Pancreatic leakage occurred in 20 cases,lung infection in 1 case,peritoneal infection in 1 case and chylous leakage in one case in LSPDP group,while pancreatic leakage in 14 cases,lung infection in 2 cases,and peritoneal infection in 2 cases in OSPDP group,all were cured by conservative therapy.Conclusions LSPDP is a safe,effective,less traumatic and more economic surgical approach for benign cystic tumors located at the body or tail of the pancreas.