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Effects of laparoscopic versus open surgery on splenic vessel patency after spleen and splenic vessel-preserving distal pancreatectomy: a retrospective multicenter study

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Abstract

Background

The aims of this study were to compare splenic vessel patency between laparoscopic and open spleen and splenic vessel-preserving distal pancreatectomy (SSVpDP), and to identify possible risk factors for poor splenic vessel patency.

Methods

This retrospective multicenter study included 116 patients who underwent laparoscopic (n = 70) or open (n = 46) SSVpDP at seven Korean tertiary medical institutions between 2004 and 2011. Clinical parameters and the splenic vessel patency assessed by abdominal computed tomography were compared between the two surgical procedures.

Results

The clinical parameters were not significantly different between both groups, except for postoperative hospital stay, which was significantly shorter in the laparoscopic group (10.4 vs. 13.5 days, P = 0.024). The splenic artery patency rate was similar in both groups (90.0 vs. 97.8 %), but the splenic vein patency rate was significantly lower in the laparoscopic group (64.3 vs. 87.0 %, P = 0.022). Univariate and multivariate analyses revealed surgical procedure [odds ratio (OR) 3.085, P = 0.043] and intraoperative blood loss (OR 4.624, P = 0.002) as independent risk factors for compromised splenic vein patency (partial or total occlusion). The splenic vein patency rate was significantly better in the late group (n = 34) than in the early period (n = 35) (79.4 vs. 48.6 %, P = 0.008).

Conclusions

Although laparoscopic SSVpDP had an advantage of shorter hospital stay compared with open surgery, it was associated with greater risk of poor splenic vein patency. However, this risk could decrease with increasing surgical experience and with efforts to minimize blood loss.

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Disclosures

Yoo-Seok Yoon, Kyoung Ho Lee, Ho-Seong Han, Jai Young Cho, Jin Young Jang, Sun-Whe Kim, Woo Jung Lee, Chang Moo Kang, Sang-Jae Park, Sung-Sik Han, Young Joon Ahn, Hee Chul Yu, and In Seok Choi have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea

    Yoo-Seok Yoon, Ho-Seong Han & Jai Young Cho

  2. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

    Kyoung Ho Lee

  3. Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    Jin Young Jang & Sun-Whe Kim

  4. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Woo Jung Lee & Chang Moo Kang

  5. Center for Liver Cancer, National Cancer Center, Ilsan, Korea

    Sang-Jae Park & Sung-Sik Han

  6. Department of Surgery, Boramae Medical Center, Seoul, Korea

    Young Joon Ahn

  7. Department of Surgery, Chonbuk National University Hospital, Jeonju, Korea

    Hee Chul Yu

  8. Department of Surgery, Konyang University Hospital, Daejeon, Korea

    In Seok Choi

Authors
  1. Yoo-Seok Yoon
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  2. Kyoung Ho Lee
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  3. Ho-Seong Han
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  7. Woo Jung Lee
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  8. Chang Moo Kang
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  9. Sang-Jae Park
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  10. Sung-Sik Han
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  11. Young Joon Ahn
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  12. Hee Chul Yu
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  13. In Seok Choi
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Corresponding author

Correspondence to Ho-Seong Han.

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Yoon, YS., Lee, K.H., Han, HS. et al. Effects of laparoscopic versus open surgery on splenic vessel patency after spleen and splenic vessel-preserving distal pancreatectomy: a retrospective multicenter study. Surg Endosc 29, 583–588 (2015). https://doi.org/10.1007/s00464-014-3701-9

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  • DOI: https://doi.org/10.1007/s00464-014-3701-9

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