To explore the clinical application value of laparoscopic spleen-preserving pancreatectomy.

Clinical data of 41 patients who underwent laparoscopic distal pancreatectomy in the First Hospital of Jilin University from January 2015 to December 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 9 patients were male and 32 female, aged 9-68 years with a median age of 42 years. All patients were diagnosed with benign or borderline tumors of the distal pancreas. The patients were divided into the spleen-preserving group (n=32) and splenectomy group (n=9) according to different surgical procedures. In the spleen-preserving group, Warshaw or Kimura spleen-preserving pancreatectomy was adopted, whereas distal pancreatectomy combined with splenectomy was performed in the splenectomy group. The surgical conditions were statistically compared between two groups by Mann-Whitney U test. The rate comparison was conducted by Chi-square test.

All patients completed the operation successfully, including22 cases of Warshaw technique and 10 cases of Kimura technique in the spleen-preserving group. The median intraoperative blood loss in the spleen-preserving group was 60(20-200) ml, significantly lower than 160 (85-280) ml in the splenectomy group (U=-4.137, P<0.05). The intraoperative blood loss in patients treated with Warshaw technique was 55(20-110) ml, significantly less than 110(30-200) ml of those with Kimura technique (U=-2.842, P<0.05). The incidences of pancreatic fistula in the spleen-preserving and splenectomy groups were 28% and 9%, respectively, where no significant difference was observed (χ2=0.125, P>0.05). The postoperative follow-up time was 1-24 months. All patients lived high quality of life and no tumor recurrence was found.

Laparoscopic spleen-preserving pancreatectomy is a safe and efficacious treatment for benign or borderline tumors of distal pancreas. Compared with the Kimura technique, Warshaw technique causes less intraoperative blood loss.