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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
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
Annals of Surgery, Volume 277, No. 1, Year 2023
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Description
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. © 2023 LWW. All rights reserved.
Authors & Co-Authors
Bjornsson, Bergthór
Sweden, Linkoping
Linköpings Universitet
Butturini, Giovanni
Unknown Affiliation
Casadei, Riccardo
Italy, Bologna
Irccs Azienda Ospedaliero-universitaria Di Bologna
Ftériche, Fadhel Samir
France, Clichy
Hôpital Beaujon
Hackert, Thilo H.
Germany, Heidelberg
Universitätsklinikum Heidelberg
Marino, Marco V.
Italy, Abano Terme
Abano Terme General Hospital
Pessaux, Patrick
France, Strasbourg
Les Hôpitaux Universitaires de Strasbourg
White, Steven Alan W.
France, Montpellier
Hôpital Saint Eloi
Dokmak, Safi
France, Clichy
Hôpital Beaujon
Edwin, B.
Norway, Oslo
Universitetet I Oslo
Hilal, Mohammed Abu
United Kingdom, Southampton
University Hospital Southampton Nhs Foundation Trust
Besselink, Marc Gerard H.
Netherlands, Amsterdam
Cancer Center Amsterdam
Statistics
Citations: 5
Authors: 12
Affiliations: 24
Identifiers
Doi:
10.1097/SLA.0000000000004963
ISSN:
00034932
Study Design
Cohort Study