Spleen-preserving distal pancreatectomy

Aim/Objective. To specify of the indications for spleen-preserving distal pancreatectomy (SP DP) and performing a prospective analysis of its results.

Materials and methods. The results of treatment in 17 patients (follow-up 12–36 months) who underwent SP DP for complications of chronic pancreatitis (CP) from 01.01.2009 to 01.01.2024 have been analyzed. There were 14 men and 3 women. Age of patients: Me = 41 [38;45,5] years. The aetiology of CP was alcohol related in 14/82.4 % (95 % CI:73,1–99,7) of these patients.

Results. There were no fatal outcomes in the immediate postoperative period. Postoperative complications were reported in 4 cases or 23.5 % (95 % CI:10,7–37,7): wound infection in 3 cases (17.6 (95 % CI:7,9–31,9)) and incomplete external pancreatic fistula in one patient (5.9 (95 % CI:2,7–12,0)). It is advisable to perform SP DP in cases where the inflammatory process is limited by tail of the pancreas, and the expansion of the main pancreatic duct is no more than 5 mm, even in cases of the “disconnected of the main pancreatic duct”. The results of the “quality-of-life” assessment obtained in the follow-up group on the eve of surgery and 12 months after SP DP (W-test, p < 0.01) confirm the feasibility of performing it in the presence of complications of CP in the distal part of the pancreas. The assessment of the relationship between the method of surgical intervention and the probability of the occurrence of “T3cDM” after SP DP made it possible to establish the presence of a mean relationship (C = 0.582).

Conclusions. Despite the relatively high incidence of postoperative complications (23.5 % (95 % CI:10.7–37.7)), SP DP is advisable to perform in cases, where the inflammatory process is separated by the tail of the pancreas. The probability of postoperative diabetes “T3cDM” (C = 0.582) is medium after SP DP.

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