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

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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

Korrel, Maarten (författare): Univ Amsterdam, Netherlands; Fdn Poliambulanza Hosp, Italy

Lof, Sanne (författare): Univ Amsterdam, Netherlands; Fdn Poliambulanza Hosp, Italy

Al Sarireh, Bilal (författare): Morriston Hosp, Wales

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Björnsson, Bergthor (författare): Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US

Boggi, Ugo (författare): Univ Pisa, Italy

Butturini, Giovanni (författare): Pederzoli Hosp, Italy

Casadei, Riccardo (författare): St Orsola Marcello Malpighi Hosp, Italy

De Pastena, Matteo (författare): Verona Univ Hosp, Italy

Esposito, Alessandro (författare): Verona Univ Hosp, Italy

Fabre, Jean Michel (författare): Univ Hosp St Eloi, France

Ferrari, Giovanni (författare): Osped Niguarda Ca Granda, Italy

Fteriche, Fadhel Samir (författare): Hosp Beaujon, France

Fusai, Giuseppe (författare): Royal Free Hosp NHS Fdn Trust, England

Koerkamp, Bas Groot (författare): Erasmus MC Canc Inst, Netherlands

Hackert, Thilo (författare): Heidelberg Univ Hosp, Germany

DHondt, Mathieu (författare): Groeninge Hosp, Belgium

Jah, Asif (författare): Addenbrookes Hosp, England

Keck, Tobias (författare): Univ Hosp Schleswig Holstein, Germany

Marino, Marco V (författare): Hosp Osped Riuniti Villa Sofia Cervello, Italy; Abano Terme Gen Hosp, Italy

Molenaar, I. Quintus (författare): Univ Utrecht, Netherlands; Univ Utrecht, Netherlands

Pessaux, Patrick (författare): Univ Hosp Strasbourg, France

Pietrabissa, Andrea (författare): Univ Hosp Pavia, Italy

Rosso, Edoardo (författare): Fdn Poliambulanza Hosp, Italy; Univ Hosp Strasbourg, France

Sahakyan, Mushegh (författare): Univ Oslo, Norway; Univ Oslo, Norway; Oslo Univ Hosp, Norway

Soonawalla, Zahir (författare): Oxford Univ Hosp NHS Fdn Trust, England

Souche, Francois Regis (författare): Univ Hosp St Eloi, France

White, Steve (författare): Univ Hosp St Eloi, France

Zerbi, Alessandro (författare): Humanitas Univ, Italy; Humanitas Res Hosp, Italy

Dokmak, Safi (författare): Hosp Beaujon, France

Edwin, Bjorn (författare): Univ Oslo, Norway; Univ Oslo, Norway

Abu Hilal, Mohammad (författare): Fdn Poliambulanza Hosp, Italy; Southampton Univ Hosp NHS Fdn Trust, England

Besselink, Marc (författare): Univ Amsterdam, Netherlands

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LIPPINCOTT WILLIAMS & WILKINS, 2023
2023
Engelska.
Ingår i: Annals of Surgery. - : LIPPINCOTT WILLIAMS & WILKINS. - 0003-4932 .- 1528-1140. ; 277:1, s. E119-E125

Relaterad länk:: https://urn.kb.se/re...; visa fler...; https://doi.org/10.1...; visa färre...

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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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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

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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

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