Our Summary

This research paper looks at two different procedures for removing part of the pancreas: one that also removes the spleen (DPS) and one that leaves the spleen intact (SPDP). The researchers analyzed 18 different studies, including over 1,000 patients, to compare the results of the two procedures.

The findings showed that the procedure keeping the spleen intact had better results. Patients had fewer infections, less blood loss during surgery, lower rates of complications, and fewer cases of clinical pancreatic fistula (a serious condition where an abnormal connection forms between the pancreas and other organs).

The researchers also compared two different techniques for preserving the spleen during the procedure. They found that the technique which preserved the blood vessels of the spleen (SVP) resulted in fewer cases of spleen infarction (when the blood supply to the spleen is blocked, causing tissue death) and fewer cases of needing to remove the spleen later on, compared to the Warshaw technique.

In conclusion, the research suggests that preserving the spleen during pancreas surgery is safer and has better short-term results. The technique that also preserves the spleen’s blood vessels seems to be the best option. However, more research is needed to confirm these findings.

FAQs

  1. What were the key findings of the comparison between the DPS and SPDP procedures?
  2. What were the benefits of the procedure that preserves the spleen’s blood vessels (SVP) compared to the Warshaw technique?
  3. What are the advantages of preserving the spleen during pancreas surgery according to the research?

Doctor’s Tip

A doctor might tell a patient undergoing a splenectomy that preserving the spleen during the procedure is important for better outcomes, such as lower infection rates, reduced blood loss, and fewer complications. They might also mention that preserving the blood vessels of the spleen during the surgery is the preferred technique for minimizing the risk of spleen infarction and the need for future spleen removal. It is important to discuss these options with your healthcare provider to determine the best course of action for your individual situation.

Suitable For

Patients who are typically recommended for splenectomy include those with conditions such as:

  1. Hodgkin’s lymphoma or other blood cancers
  2. Severe cases of anemia
  3. Enlarged spleen causing pain or discomfort
  4. Noncancerous conditions affecting the spleen, such as hereditary spherocytosis or idiopathic thrombocytopenic purpura
  5. Trauma or injury to the spleen causing severe bleeding or rupture

It is important for patients to discuss the potential risks and benefits of splenectomy with their healthcare provider to determine the best course of treatment for their specific condition.

Timeline

Before splenectomy:

  1. Patient is diagnosed with a condition that requires splenectomy, such as certain types of cancer, blood disorders, or trauma to the spleen.
  2. Patient undergoes pre-operative testing and evaluation to assess their overall health and determine the best course of treatment.
  3. Patient receives information about the procedure, risks, and potential complications.
  4. Patient may undergo additional preparatory steps, such as blood transfusions or vaccinations to prevent infections.
  5. Surgery is scheduled and patient undergoes splenectomy.

After splenectomy:

  1. Patient is closely monitored in the hospital for any complications, such as bleeding, infection, or blood clots.
  2. Patient may experience pain, fatigue, and discomfort in the days following surgery.
  3. Patient is gradually allowed to resume normal activities, with restrictions on heavy lifting and strenuous exercise.
  4. Patient may need to take medications to prevent infections, such as antibiotics or vaccines.
  5. Patient receives follow-up care to monitor their recovery and manage any long-term effects of splenectomy, such as increased risk of infections or blood clotting disorders.

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. What are the potential risks and complications of splenectomy?
  2. How will my body function without a spleen?
  3. Will I need any vaccinations or medications after the procedure to prevent infections?
  4. What is the recovery process like after a splenectomy?
  5. Are there any long-term effects of living without a spleen?
  6. Will preserving my spleen during the procedure have any benefits for my overall health?
  7. What is the difference in outcomes between procedures that remove the spleen versus those that preserve it?
  8. What is the best technique for preserving the spleen during the procedure, and why?
  9. How will the decision to preserve or remove my spleen impact my future health and potential need for additional surgeries?
  10. Are there any specific lifestyle changes or precautions I should take after a splenectomy?

Reference

Authors: Shi N, Liu SL, Li YT, You L, Dai MH, Zhao YP. Journal: Ann Surg Oncol. 2016 Feb;23(2):365-74. doi: 10.1245/s10434-015-4870-z. PMID: 26493758