The efficacy of spleen-preserving distal pancreatectomy with or without splenic vessel preservation: a meta-analysis

Background: Spleen-preserving distal pancreatectomy can be performed with splenic vessel preservation (SPDP-SVP) or splenic vessel resection (SPDP-SVR). This meta-analysis aimed to evaluate the clinical outcomes of patients undergoing SPDP-SVP or SPDP-SVR. Method: A systematic literature search of PubMed, Embase, and the Cochrane Library was performed. The operative time, estimated blood loss, postoperative complications, pancreatic fistula (Grade B+C) rates, splenic infarction rates, gastric/perigastric varices rates and postoperative hospital stay were evaluated. RevMan 5.3 software was used to evaluate the differences between groups. Results: Nine studies involving 639 patients were included in this meta-analysis, of whom 402 underwent SPDP-SVP and 237 underwent SPDP-SVR. Patients who underwent SPDP-SVP had lower splenic infarction and gastric/perigastric varices rates. The operative time, estimated blood loss, postoperative complications, pancreatic fistula (Grade B+C) rates and postoperative hospital stays were comparable between these two groups. Conclusions: SPDP-SVP and SPDP-SVR are both safe, feasible procedures for the management of benign or low-grade malignant pancreatic body or tail tumors. However, SPDP-SVR is related to higher incidence rates of early splenic ischemia and gastric/perigastric varices.