Dynamic hematological changes in patients undergoing distal pancreatectomy with or without splenectomy: a population-bas
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RESEARCH ARTICLE
Open Access
Dynamic hematological changes in patients undergoing distal pancreatectomy with or without splenectomy: a population‑based cohort study Ming Cui1†, Jing‑Kai Liu1†, Bang Zheng2†, Qiao‑Fei Liu1, Lu Zhang3, Li Zhang4, Jun‑Chao Guo1, Meng‑Hua Dai1, Tai‑Ping Zhang1 and Quan Liao1*
Abstract Background: The clinical outcomes of patients who received distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) have been generally investigated. However, postoperative hemato‑ logical changes after distal pancreatectomy with or without splenectomy are poorly understood. Methods: Information from patients undergoing distal pancreatectomy (DP) between January 2014 and June 2019 at a single institution was reviewed. A linear mixed-effects model was used to compare dynamic hematological changes between different groups. Results: A total of 302 patients who underwent DP were enrolled. In the long term, most postoperative hematologi‑ cal parameters remained significantly higher than preoperative levels in the DPS group, while postoperative lym‑ phocyte, monocyte, basophil, and platelet levels returned to preoperative levels in the SPDP group. All postoperative hematological parameters except for red blood cell count and serum hemoglobulin level were significantly higher in the DPS group than in the SPDP group. There were no significant differences in hematological changes between the splenic vessel preservation (SVP) and Warshaw technique (WT) groups. Conclusions: Postoperative hematological changes were significantly different between the DPS and SPDP groups. Compared to DPS, SPDP reduced abnormal hematological changes caused by splenectomy. SVP and WT were com‑ parable in terms of postoperative hematological changes. Keywords: Distal pancreatectomy, Splenectomy, Spleen preservation, Leukocyte, Platelet Background Distal pancreatectomy (DP) is the standard operation for lesions located at the body or tail (left side) of the pancreas. Splenectomy is often involved in DP due to *Correspondence: [email protected] † Ming Cui, Jing-Kai Liu, and Bang Zheng contributed equally to this work. 1 Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China Full list of author information is available at the end of the article
anatomical proximity and the shared principal vessels between the spleen and left pancreas. To reduce the risks associated with removing the spleen, which functions as a hematologic and immunological organ, spleen-preserving distal pancreatectomy (SPDP) has been established, including two major methods: the conventional splenic vessel preservation (SVP) technique and the short gastric vessel-preserving technique, or the Warshaw technique (WT) [1–3]. Recently, SPDP has been increasingly
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