Introduction: The pupose of this study is to compare clinical results of spleen preserving laparoscopic distal pancreatectomy(SPLDP) with en bloc laparoscpic distal pancreatectomy (LDPS).
Methods: From March 2005 to September 2008, 55 cases of SPLDP and 95 LDPS were performed at our institution and compared retrospectivele. Enrolled periods were divided to four eras chronologically by 11 months respectively.
Results: Demographics including patient’s age, gender, BMI were not different between the two groups. Final pathologic diagnosis was diverse including cystic tumor, SPT, IPMN, cancer, neuroendocrine tumor etc and was also not different between the two groups. Tumor location, operative time, tumor size, perioperative transfusion, hospital stay and postoperative complication was not different between two groups, but interestingly pancreatic stump leakage rate was significantly higher in LDPS group.(3.8% VS 11.9%, p=0.038)
Mean operative time was gradually shortened by eras (Era 1: 236.3, Era 2: 223.6, Era 3: 192.4, Era 4: 185.4) and proportion of SPLDP was increased by eras from 1.9%, 5.8%, 38.5% and 53.8% respectively.
Conclusions: SPLDP might be technically more difficult than LDPS, especially in initial stage of laparoscopic pancreatic surgery. After overcoming learning curve, SPLDP can be perfomed safely and possilbly within shorter time. SPLDP should be tried firstly to give maximal benefits of minimal invasive surgery to patients, whenever possible.
Program Number: P430