title: Distal pancreatectomy for benign and low grade malignant tumors: Short-term postoperative outcomes of spleen preservation-A systematic review and update meta-analysis.
abstract: BACKGROUND
  The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP).
  
  
  METHODS
  Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included.
  
  
  RESULTS
  Meta-analysis of included data showed SPDP patients had significantly less operative blood loss, shorter duration of hospitalization, lower incidence of fluid collection and abscess, lower incidence of postoperative splenic and portal vein thrombosis, and lower incidence of new onset postoperative diabetes. For the whole group, there was no difference in incidence of postoperative pancreatic fistula (POPF) (RR = 0.95; 95%CI 0.65-1.40, P = 0.80), however, subgroup analysis of studies using ISGPF criteria showed that DPS patients had increased rates of Grade B/C POPF (RR = 1.35; 95%CI 1.08-1.70, P = 0.01).
  
  
  CONCLUSIONS
  SPDP for benign and low grade malignant tumors is associated with shorter hospital stay and decreased morbidity compared to DPS. J. Surg. Oncol. 2017;115:137-143. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Pendola
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gadde
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ripat
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Rishika
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Omar
authors.initials: O
authors.lastname: Picado
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Laila
authors.initials: L
authors.lastname: Lobo
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Danny
authors.initials: D
authors.lastname: Sleeman
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Livingstone
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Nipun
authors.initials: N
authors.lastname: Merchant
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Miami - Miller School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami - Miller School of Medicine, Miami, Florida.
authors.forename: Danny
authors.initials: D
authors.lastname: Yakoub
mesh_terms: D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009926:Organ Preservation / Q000379:methods*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications; D013154:Spleen / Q000098:blood supply* / Q000601:surgery; D016896:Treatment Outcome
keywords: distal pancreatectomy; postoperative pancreatic fistula; spleen preserving distal pancreatectomy