Spleen-preserving distal pancreatectomy without division of splenic artery and vein as a procedure for benign distal pancreatic lesion.

BACKGROUND: To assess the safety and the clinical outcome of distal pancreatectomy, with preservation of the spleen as well as splenic artery and vein, for benign distal pancreatic lesions. METHODS: Five consecutive patients with benign distal pancreatic lesions (3 with insulinoma, 1 with non-functioning islet cell tumor and 1 with serous cystadenoma) underwent spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. Prograde distal pancreatectomy was performed for 4 patients and retrograde pancreatectomy for the other. The operative time, blood loss due to surgery, length of post-operative hospitalization and post-operative complications were analyzed and evaluated. RESULTS: Surgery was successful for all 5 patients. Whilst 2 of the patients revealed major medical disease, no post-surgical complications were experienced by any of the 5 patients. The mean operative time, extent of blood loss, and postoperative hospital stay were, respectively, 238 minutes (range 175-270), 170 ml (range 50-300), and 8.4 days (range 6 - 15). CONCLUSION: From our experience, spleen-preserving distal pancreatectomy can be safely performed with the conservation of the splenic artery and vein. Our result revealed that this well-known procedure can be improved in terms of blood loss, surgical duration and length of hospital stay. We believe that this procedure should be performed for benign lesions of the distal pancreas whenever indicated and possible.