Comparison of infectious complications after spleen preservation versus splenectomy during laparoscopic distal pancreatectomy for benign or low-grade malignant pancreatic tumors: A multicenter, propensity score-matched analysis

被引：6

作者：

Lee, Woohyung ^{[1
]}

Hwang, Dae Wook ^{[1
]}

Han, Ho-Seong ^{[2
]}

Han, In Woong ^{[3
]}

Heo, Jin Seok ^{[3
]}

Unno, Michiaki ^{[4
]}

Ishida, Masaharu ^{[4
]}

Tajima, Hiroshi ^{[5
]}

Nishizawa, Nobuyuki ^{[5
]}

Nakata, Kohei ^{[6
]}

Seyama, Yasuji ^{[7
]}

Isikawa, Yoshiya ^{[8
]}

Hwang, Ho Kyoung ^{[9
]}

Jang, Jin-Young ^{[10
]}

Hong, Taeho ^{[11
]}

Park, Joon Seong ^{[12
]}

Kim, Hee Joon ^{[13
]}

Jeong, Chi-Young ^{[14
]}

Matsumoto, Ippei ^{[15
]}

Yamaue, Hiroki ^{[16
]}

Kawai, Manabu ^{[16
]}

Ohtsuka, Masayuki ^{[17
]}

Mizuno, Shugo ^{[18
]}

Asakuma, Mitsuhiro ^{[19
]}

Soejima, Yuji ^{[20
]}

Hirashita, Teijiro ^{[21
]}

Sho, Masayuki ^{[22
]}

Takeda, Yutaka ^{[23
]}

Park, Jeong-Ik ^{[24
]}

Kim, Yong Hoon ^{[25
]}

Kim, Hwa Jung ^{[26
]}

Yamamoto, Masakazu ^{[27
]}

Endo, Itaru ^{[28
]}

Nakamura, Masafumi ^{[6
]}

Yoon, Yoo-Seok ^{[2
]}

机构：

[1] Univ Ulsan, Asan Med Ctr, Dept Surg, Coll Med,Div Hepatobiliary & Pancreat Surg, Seoul, South Korea

[2] Seoul Natl Univ, Bundang Hosp, Dept Surg, 300 Gumi Dong, Seongnam Si 13620, Gyeonggi Do, South Korea

[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Div Hepatobiliary & Pancreat Surg,Dept Surg, Seoul, South Korea

[4] Tohoku Univ, Dept Surg, Sendai, Miyagi, Japan

[5] Kitasato Univ, Dept Gen Pediat & Lepatobiliary Pancreat Surg, Sch Med, Sagamihara, Kanagawa, Japan

[6] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Oncol, Fukuoka, Japan

[7] Komagome Hosp, Dept Hepatobiliary Pancreat Surg, Tokyo Metropolitan Canc & Infect Dis Ctr, Tokyo, Japan

[8] Tokyo Med & Dent Univ, Grad Sch Med, Dept Hepatobiliary & Pancreat Surg, Tokyo, Japan

[9] Yonsei Univ, Dept Surg, Div HBP Surg, Coll Med, Seoul, South Korea

[10] Seoul Natl Univ, Coll Med, Seoul Natl Univ Hosp, Dept Surg,Div Hepatobiliary & Pancreat Surg, Seoul, South Korea

[11] Catholic Univ Korea, Coll Med, Seoul St Marys Hosp, Div Hepatobiliary & Pancreas Surg,Dept Surg, Seoul, South Korea

[12] Yonsei Univ, Gangnam Severance Hosp, Dept Surg, Coll Med, Seoul, South Korea

[13] Chonnam Natl Univ Med Sch, Chonnam Natl Univ Hosp, Dept Surg, Div Hepatopancreatobiliary Surg, Gwangju, South Korea

[14] Gyeongsang Natl Univ, Coll Med, Gyeongsang Natl Univ Hosp, Dept Surg, Jinju, South Korea

[15] Kindai Univ, Fac Med, Dept Surg, Higashiosaka, Osaka, Japan

[16] Wakayama Med Univ, Dept Surg 2, Wakayama, Japan

[17] Chiba Univ, Grad Sch Med, Dept Gen Surg, Chiba, Japan

[18] Mie Univ, Hepatobiliary Pancreat & Transplant Surg, Grad Sch Med, Tsu, Mie, Japan

[19] Osaka Med & Pharmaceut Univ, Dcpartment Gen & Gastroenterol Surg, Takatsuki, Osaka, Japan

[20] Shinshu Univ, Dept Surg, Sch Med, Div Gastroenterol Hepatobiliary Pancreat Transpla, Matsumoto, Nagano, Japan

[21] Oita Univ, Dept Gastroenterol & Pediat Surg, Fac Med, Oita, Japan

[22] Nara Med Univ, Dept Surg, Kashihara, Nara, Japan

[23] Kansai Rosai Hosp, Amagasaki, Hyogo, Japan

[24] Univ Ulsan, Ulsan Univ Hosp, Coll Med, Dept Surg, Ulsan, South Korea

[25] Keimyung Univ, Dept Surg, Dongsan Hosp, Daegu, South Korea

[26] Asan Med Ctr, Dept Clin Epidemiol & Biostat, Seoul, South Korea

[27] Tokyo Womans Med Univ, Inst Gastroenterol, Dept Surg, Tokyo, Japan

[28] Yokohama City Univ, Dept Gastroenterol Surg, Yokohama, Kanagawa, Japan

来源：

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES | 2023年 / 30卷 / 02期

关键词：

distal pancreatectomy; infectious complication; laparoscopy; spleen preservation; splenectomy; POSTOPERATIVE OUTCOMES; SPLENIC PRESERVATION; POSTSPLENECTOMY; EXPERIENCE; DRAINAGE; PATENCY; UPDATE; VOLUME;

D O I：

10.1002/jhbp.1213

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Previous studies have reported contrasting results regarding the advantages of spleen preservation during laparoscopic distal pancreatectomy (LDP) for preventing infectious complications. Methods A total of 3787 patients who underwent LDP for benign or low-grade malignant pancreatic disease in 92 centers across Korea and Japan were included in this retrospective study. Postoperative infectious complications and other complications were compared between LDP with splenectomy (LDPS) and LDP with spleen preservation (LSPDP) by propensity score matching (PSM) analysis. Results After PSM, the LSPDP group had a lower rate of overall infectious complications (P = .079) and a significantly lower rate of intra-abdominal abscess (P = .014) compared with the LDPS group. Within the LSPDP group, the vessel preservation subgroup had a significantly higher rate of infectious complications (P = .002) compared with the vessel resection subgroup. Low-volume centers had a higher rate of intra-abdominal abscess than high-volume centers in the LSPDP group (P = .001) and the splenic vessel preservation subgroup (P = .003). Conclusions Spleen preservation in LDP for benign or borderline malignant pancreatic diseases was advantageous in lowering the risk of infectious complications, specifically intra-abdominal abscess. However, the risk of intra-abdominal abscess may differ according to the level of surgeon's experience.

引用

页码：252 / 262

页数：11

共 22 条

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