title: Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis.
abstract: BACKGROUND
  Despite the emphasis on its role, the spleen has commonly been removed in distal pancreatectomy. We designed this study to evaluate the efficacy of spleen salvage during laparoscopic distal pancreatectomy for patients with benign and borderline malignant tumors.
  
  
  METHODS
  From February 2005 to December 2010, 40 patients underwent spleen-preserving laparoscopic distal pancreatectomy (Sp-Lap DP) and 32 patients underwent laparoscopic distal pancreatosplenectomy (Lap DPS). Medical records were retrospectively reviewed, and a specially designed questionnaire was administered to the patients for the follow-up study.
  
  
  RESULTS
  The demographics and final diagnoses were similar between the two groups. The operative time was significantly longer in the Sp-Lap DP group (303.9 ± 136.0 versus 239.0 ± 94.9 min, p = 0.024). Patients in the Lap DPS group had more postoperative pancreatic fistulas of higher grade (p = 0.026). A higher grade of postoperative complications occurred more frequently in the Lap DPS group (p = 0.003). Consequently, postoperative hospital stay was significantly shorter for Sp-Lap DP than for Lap DPS patients (7.1 ± 2.3 versus 12.5 ± 10.8 days, p = 0.004). On the follow-up survey, episodes of common cold or flu were apparently more frequent in the Lap DPS group (p = 0.026). Despite the similar recovery period between the two groups, significantly more patients who underwent Lap DPS felt fatigue (p = 0.014) and poorer health condition (p = 0.042).
  
  
  CONCLUSIONS
  In addition to frequent higher-grade complications and prolonged hospital stays, Lap DPS appeared to impair patient quality of life based on follow-up survey. Even an effort to preserve adult spleen in distal pancreatectomy is worthwhile.
authors.affiliation: Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #204, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Choi
authors.forename: Mi Ae
authors.initials: MA
authors.lastname: Seo
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D013154:Spleen; D011795:Surveys and Questionnaires; D016896:Treatment Outcome