To evaluate the clinical application value of minimally invasive spleen-preserving distal pancreatectomy (Kimura) in patients with benign and low-grade malignant pancreatic tumors.

Clinical data of 68 patients with benign and low-grade pancreatic tumors who underwent minimally invasive spleen-preserving distal pancreatectomy (Kimura) in Huadong Hospital Affiliated to Fudan University from May 2010 to December 2017 were retrospectively analyzed. Among them, 27 patients were male and 41 female, aged 14-82 years with a median age of 52 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. According to different surgical methods, all patients were divided into the robot group and laparoscopic group. According to whether spleen was preserved or not, each group was further divided into the spleen-preserving group and splenectomy group. The short-term surgical efficacy was statistically compared between the spleen-preserving and splenectomy groups, and between the robot and laparoscopic groups. The operation time and intraoperative blood loss were compared by using t test. The rate comparison was conducted by Chi-square test or Fisher's exact probability.

All 68 patients underwent Kimura distal pancreatectomy with a success spleen-preserving rate 74%(50/68), and it was 73%(16/22) in robot group and 74%(34/46) in laparoscopic group, where no significant difference was observed between two groups (χ²=0.005, P>0.05). The operation time and intraoperative blood loss in laparoscopic group were (152±9) min and (113±23) ml, significantly less than (238±22) min and (286±71) ml in robot group (t=-3.65, -2.95; P<0.05). No perioperative death occurred. No significant difference was observed in the incidence of pancreatic fistula and postoperative intra-abdominal infection between the laparoscopic and robot group, neither between the spleen-preserving and splenectomy group (P>0.05).

Minimally invasive spleen-preserving distal pancreatectomy (Kimura) is a safe and feasible operation for patients with benign and low-grade pancreatic tumors. Laparoscopic and robotic operations yield equivalent success rate of spleen-preserving, whereas laparoscopic operation has certain advantages in operation time and intraoperative blood loss, which can be the primary choice.