title: The value of splenic preservation with distal pancreatectomy.
abstract: OBJECTIVE
  Splenic-preserving distal pancreatectomy for benign or low-grade malignant disease is associated with decreased perioperative morbidity compared with conventional distal pancreatectomy with splenectomy.
  
  
  METHODS
  A retrospective review of a prospective database of patients.
  
  
  METHODS
  Memorial Sloan-Kettering Cancer Center, New York, NY.
  
  
  METHODS
  All patients (N = 211) undergoing distal pancreatectomy.
  
  
  METHODS
  Perioperative complications, length of postoperative stay, and overall survival times were analyzed.
  
  
  RESULTS
  After excluding patients with adenocarcinoma and those who had other major organ resection, 125 patients underwent distal pancreatectomy for benign or low-grade malignant disease with splenectomy (n = 79) or splenic preservation (n = 46). Perioperative complications occurred in 39 (49%) of the 79 patients following splenectomy and 18 (39%) of the 46 patients following splenic preservation (P =.21). Perioperative infectious complications and severe complications were significantly higher in the splenectomy group (28% and 11%) compared with the splenic preservation group (9% and 2%) (P =.01 and.05), respectively. Length of hospital stay was 9 days (range, 5-41 days) following splenectomy and 7 days (range, 5-26 days) following splenic preservation (P<.01). No difference in length of surgery, units of blood transfused, or perioperative mortality was noted between groups.
  
  
  CONCLUSIONS
  Splenic preservation following distal pancreatectomy for benign or low-grade malignant disease is safe and is associated with a reduction in perioperative infectious complications, severe complications, and length of hospital stay compared with conventional distal pancreatectomy with splenectomy. Therefore, splenic preservation should be considered in this group of patients.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, NY, NY 10021, USA.
authors.forename: Margo
authors.initials: M
authors.lastname: Shoup
authors.forename: Murray F
authors.initials: MF
authors.lastname: Brennan
authors.forename: Kertrisa
authors.initials: K
authors.lastname: McWhite
authors.forename: Denis H Y
authors.initials: DH
authors.lastname: Leung
authors.forename: David
authors.initials: D
authors.lastname: Klimstra
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Conlon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013154:Spleen / Q000098:blood supply*; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome