Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) with Preservation of Splenic Vessels: An Inferior-Posterior Approach.

Objective: To summarize the operation experience of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with preservation of splenic vessels by an inferior-posterior dissection of the pancreatic body and evaluate its feasibility.

Methods: Patients undergoing LSPDS at Ningbo Li Huili Hospital and Ningbo Li Huili Eastern Hospital from January 2014 to April 2017 were recruited in this study and were analyzed retrospectively. They were divided into two groups based on the surgical approach: the inferior-posterior approach group and the other approach group. We sought to compare outcomes of the two groups.

Results: The LSPDP procedure was completed successfully in 49 cases, and 48 patients had their splenic artery and vein preserved, including 26 cases in the inferior-posterior approach group and 22 cases in the other approach group. There were no significant differences between the two groups with respect to age ( p = 0.18), sex ( p = 0.56), preoperative diabetes ( p = 1.00), ASA grading ( p = 1.00), tumor size ( p = 0.91), intraoperative blood loss ( t = -0.01, p = 0.99), hospital stay ( t = -0.02, p = 0.98), and pancreatic fistula rates ( p = 1.00). Patients undergoing LSPDP by the inferior-posterior approach had a shorter operative time ( t = -4.13, p < 0.001) than the other approach group.

Conclusions: LSPDS by the inferior-posterior approach associated with shorter operative time is safe and feasible.