The value of splenic preservation with distal pancreatectomy

The value of splenic preservation with distal pancreatectomy
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DOI:
10.1001/archsurg.137.2.164
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发表时间:
2002-02-01
影响因子:
--
通讯作者:
Conlon, KC
Conlon, KC
中科院分区:
其他
文献类型:
--
作者:
Shoup, M;Brennan, MF;Conlon, KC

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假设:与传统的胰尾切除术联合脾切除术相比,胰尾切除术治疗良性或低度恶性疾病的保脾胰尾切除术可降低围手术期发病率。设计:对前瞻性患者数据库进行回顾性分析。地点:纪念斯隆-凯特琳癌症中心,纽约,NY。患者:所有接受胰尾切除术的患者(N = 211)。主要结果指标:围手术期并发症,术后住院时间,总生存时间进行了analysed.Results:排除腺癌和其他主要器官切除的患者后,125例患者进行了胰腺远端切除术的良性或低度恶性疾病脾切除术(n = 79)或脾保留(n=46)。79例脾切除术患者中有39例(49%)发生围手术期并发症,46例脾保留术患者中有18例(39%)发生围手术期并发症(P= 0.21)。脾切除组的围手术期感染并发症和严重并发症(28%和11%)明显高于脾保留组(9%和2%)(P= 0.01和0.05)。脾切除术后住院时间为9天(范围,5-41天),脾保留术后住院时间为7天(范围,5-26天)(P
Hypothesis: Splenic-preserving distal pancreatectomy for benign or low-grade malignant disease is associated with decreased perioperative morbidity compared with conventional distal pancreatectomy with splenectomy.Design: A retrospective review of a prospective database of patients.Setting: Memorial Sloan-Kettering Cancer Center, New York, NY.Patients: All patients (N = 211) undergoing distal pancreatectomy.Main Outcome Measures: Perioperative complications, length of postoperative stay, and overall survival times were analyzed.Results: After excluding patients with adenocarcinoma and those who had other major organ resection, 125 patients underwent distal pancreatectomy for benign or low-grade malignant disease with splenectomy (n = 79) or splenic preservation (n=46). Perioperative complications occurred in 39 (49%) of the 79 patients following splenectomy and 18 (39%) of the 46 patients following splenic preservation (P=.21). Perioperative infectious complications and severe complications were significantly higher in the splenectomy group (28% and 11%) compared with the splenic preservation group (9% and 2%) (P=.01 and .05), respectively. Length of hospital stay was 9 days (range, 5-41 days) following splenectomy and 7 days (range, 5-26 days) following splenic preservation (P