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Comparison of infectious complications after spleen preservation versus splenectomy during laparoscopic distal pancreatectomy for benign or low-grade malignant pancreatic tumors: A multicenter, propensity score-matched analysis

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Author(s)
Woohyung LeeDae Wook HwangHo-Seong HanIn Woong HanJin Seok HeoMichiaki UnnoMasaharu IshidaHiroshi TajimaNobuyuki NishizawaKohei NakataYasuji SeyamaYoshiya IsikawaHo Kyoung HwangJin-Young JangTaeho HongJoon Seong ParkHee Joon KimChi-Young JeongIppei MatsumotoHiroki YamaueManabu KawaiMasayuki OhtsukaShugo MizunoMitsuhiro AsakumaYuji SoejimaTeijiro HirashitaMasayuki ShoYutaka TakedaJeong-Ik ParkYong Hoon KimHwa Jung KimMasakazu YamamotoItaru EndoMasafumi NakamuraYoo-Seok Yoon
Keimyung Author(s)
Kim, Yong Hoon
Department
Dept. of Surgery (외과학)
Journal Title
J Hepatobiliary Pancreat Sci
Issued Date
2023
Volume
30
Issue
2
Keyword
distal pancreatectomyinfectious complicationlaparoscopyspleen preservationsplenectomy
Abstract
Background:
Previous studies have reported contrasting results regarding the advantages of spleen preservation during laparoscopic distal pancreatectomy (LDP) for preventing infectious complications.

Methods:
A total of 3787 patients who underwent LDP for benign or low-grade malignant pancreatic disease in 92 centers across Korea and Japan were included in this retrospective study. Postoperative infectious complications and other complications were compared between LDP with splenectomy (LDPS) and LDP with spleen preservation (LSPDP) by propensity score matching (PSM) analysis.

Results:
After PSM, the LSPDP group had a lower rate of overall infectious complications (P = .079) and a significantly lower rate of intra-abdominal abscess (P = .014) compared with the LDPS group. Within the LSPDP group, the vessel preservation subgroup had a significantly higher rate of infectious complications (P = .002) compared with the vessel resection subgroup. Low-volume centers had a higher rate of intra-abdominal abscess than high-volume centers in the LSPDP group (P = .001) and the splenic vessel preservation subgroup (P = .003).

Conclusions:
Spleen preservation in LDP for benign or borderline malignant pancreatic diseases was advantageous in lowering the risk of infectious complications, specifically intra-abdominal abscess. However, the risk of intra-abdominal abscess may differ according to the level of surgeon's experience.
Keimyung Author(s)(Kor)
김용훈
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1868-6982
Source
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.1213
DOI
10.1002/jhbp.1213
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44720
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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