Short-term outcomes after spleen-preserving minimally invasive distal pancreatectomy with or without preservation of splenic vessels: a Pan-European retrospective study in high-volume centers
Objective: - To compare short-term clinical outcomes after Kimura and Warshaw MIDP. - Background: - Spleen preservation during distal pancreatectomy can be achieved by either preservation (Kimura) or resection (Warshaw) of the splenic vessels. Multicenter studies reporting...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 2023
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| In: |
Annals of surgery
Year: 2023, Volume: 277, Issue: 1, Pages: e119-e125 |
| ISSN: | 1528-1140 |
| DOI: | 10.1097/SLA.0000000000004963 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/SLA.0000000000004963 Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/annalsofsurgery/Fulltext/2023/01000/Short_term_Outcomes_After_Spleen_preserving.44.aspx 
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| Author Notes: | Maarten Korrel, Sanne Lof, Bilal Al Sarireh, Bergthor Björnsson, Ugo Boggi, Giovanni Butturini, Riccardo Casadei, Matteo De Pastena, Alessandro Esposito, Jean Michel Fabre, Giovanni Ferrari, Fadhel Samir Fteriche, Giuseppe Fusai, Bas Groot Koerkamp, Thilo Hackert, Mathieu D’Hondt, Asif Jah, Tobias Keck, Marco V. Marino, I. Quintus Molenaar, Patrick Pessaux, Andrea Pietrabissa, Edoardo Rosso, Mushegh Sahakyan, Zahir Soonawalla, Francois Regis Souche, Steve White, Alessandro Zerbi, Safi Dokmak, Bjorn Edwin, Mohammad Abu Hilal, and Marc Besselink, for the European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) |
MARC
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| 245 | 1 | 0 | |a Short-term outcomes after spleen-preserving minimally invasive distal pancreatectomy with or without preservation of splenic vessels |b a Pan-European retrospective study in high-volume centers |c Maarten Korrel, Sanne Lof, Bilal Al Sarireh, Bergthor Björnsson, Ugo Boggi, Giovanni Butturini, Riccardo Casadei, Matteo De Pastena, Alessandro Esposito, Jean Michel Fabre, Giovanni Ferrari, Fadhel Samir Fteriche, Giuseppe Fusai, Bas Groot Koerkamp, Thilo Hackert, Mathieu D’Hondt, Asif Jah, Tobias Keck, Marco V. Marino, I. Quintus Molenaar, Patrick Pessaux, Andrea Pietrabissa, Edoardo Rosso, Mushegh Sahakyan, Zahir Soonawalla, Francois Regis Souche, Steve White, Alessandro Zerbi, Safi Dokmak, Bjorn Edwin, Mohammad Abu Hilal, and Marc Besselink, for the European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) |
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| 520 | |a Objective: - To compare short-term clinical outcomes after Kimura and Warshaw MIDP. - Background: - Spleen preservation during distal pancreatectomy can be achieved by either preservation (Kimura) or resection (Warshaw) of the splenic vessels. Multicenter studies reporting outcomes of Kimura and Warshaw spleen-preserving MIDP are scarce. - Methods: - Multicenter retrospective study including consecutive MIDP procedures intended to be spleen-preserving from 29 high-volume centers (≥15 distal pancreatectomies annually) in 8 European countries. Primary outcomes were secondary splenectomy for ischemia and major (Clavien-Dindo grade ≥III) complications. Sensitivity analysis assessed the impact of excluding (“rescue”) Warshaw procedures which were performed in centers that typically (>75%) performed Kimura MIDP. - Results: - Overall, 1095 patients after MIDP were included with successful splenic preservation in 878 patients (80%), including 634 Kimura and 244 Warshaw procedures. Rates of clinically relevant splenic ischemia (0.6% vs 1.6%, P = 0.127) and major complications (11.5% vs 14.4%, P = 0.308) did not differ significantly between Kimura and Warshaw MIDP, respectively. Mortality rates were higher after Warshaw MIDP (0.0% vs 1.2%, P = 0.023), and decreased in the sensitivity analysis (0.0% vs 0.6%, P = 0.052). Kimura MIDP was associated with longer operative time (202 vs 184 minutes, P = 0.033) and less blood loss (100 vs 150 mL, P < 0.001) as compared to Warshaw MIDP. Unplanned splenectomy was associated with a higher conversion rate (20.7% vs 5.0%, P < 0.001). - Conclusions: - Kimura and Warshaw spleen-preserving MIDP provide equivalent short-term outcomes with low rates of secondary splenectomy and postoperative morbidity. Further analyses of long-term outcomes are needed. | ||
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