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자료유형
학술저널
저자정보
홍승수 (연세대학교) 차성환 (연세대학교) 황호경 (연세대학교) 이우정 (연세대학교) 강창무 (연세대학교)
저널정보
연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제63권 제6호
발행연도
2022.6
수록면
564 - 569 (6page)
DOI
10.3349/ymj.2022.63.6.564

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Purpose: In the past, spleen preservation during distal pancreatectomy (DP) was preferred; however, more recent studies reportedcomparable results between splenectomy and spleen preserving. We retrospectively reviewed patients in a single center whounderwent laparoscopic DP with/without splenectomy, and evaluated the chronologic changes of surgical outcomes of the twoprocedures. Materials and Methods: Patients who underwent laparoscopic DP with or without splenectomy due to benign/borderline tumorfrom 2005 to 2019 were included in this study. We divided this period into Era 1 (2005–2012) and Era 2 (2013–2019), and comparedthe chronological evolution of surgical outcomes of laparoscopic distal pancreatosplenectomy (LDPS) to those of laparoscopicspleen-preserving distal pancreatectomy (LSpDP), including the long-term postoperative immunologic profiles. Results: A total of 198 cases were included (LSpDP: 80 cases; LDPS: 118 cases). As the period changed from Era 1 to Era 2, the ratioof LSpDP decreased and the surgical outcomes of LDPS improved. In Era 1, LSpDP group showed superior results comparedto LDPS group in terms of hospital days and postoperative pancreatic fistula ratio; however, in Era 2, the surgical outcomesshowed no statistical differences. No significant differences were observed in all of the immunologic markers. Conclusion: We carefully conclude that during laparoscopic DP, combined splenectomy can be equivalent to spleen preservingin surgical and immunological outcomes, and inevitable splenectomy can be safely conducted.

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