{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:12:55Z","timestamp":1791972775385,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,8,16]],"date-time":"2018-08-16T00:00:00Z","timestamp":1534377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Minimally invasive distal pancreatectomy (<jats:styled-content style=\"fixed-case\">MIDP<\/jats:styled-content>) has gained in popularity recently. However, there is no consensus on whether to preserve the spleen or not. In this study, we compared <jats:styled-content style=\"fixed-case\">MIDP<\/jats:styled-content> outcomes between spleen\u2010preserving distal pancreatectomy (<jats:styled-content style=\"fixed-case\">SPDP<\/jats:styled-content>) and distal pancreatectomy with splenectomy (<jats:styled-content style=\"fixed-case\">DPS<\/jats:styled-content>); as well as outcomes between splenic vessel preservation (<jats:styled-content style=\"fixed-case\">SVP<\/jats:styled-content>) and Warshaw's technique (<jats:styled-content style=\"fixed-case\">WT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of PubMed (<jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>) and Cochrane Library was conducted and the reference lists of review articles were hand\u2010searched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen relevant studies with 769 patients were selected for meta\u2010analyses of <jats:styled-content style=\"fixed-case\">DPS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SPDP<\/jats:styled-content>, while another 15 studies with 841 patients were used for the analysis between <jats:styled-content style=\"fixed-case\">SVP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">WT<\/jats:styled-content>. Compared with the <jats:styled-content style=\"fixed-case\">DPS<\/jats:styled-content> group, <jats:styled-content style=\"fixed-case\">SPDP<\/jats:styled-content> patients had significantly lower incidences of infectious complications (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.006) and pancreatic fistula (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002), shorter operative time (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and less blood loss (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). Compared with <jats:styled-content style=\"fixed-case\">WT<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> SVP<\/jats:styled-content> patients had significantly lower incidences of splenic infarction (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and secondary splenectomy (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). Subanalysis for laparoscopic surgery alone had similar results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on this study, <jats:styled-content style=\"fixed-case\">SPDP<\/jats:styled-content> has significantly superior outcomes compared to <jats:styled-content style=\"fixed-case\">DPS<\/jats:styled-content>. When a spleen is preserved, <jats:styled-content style=\"fixed-case\">SVP<\/jats:styled-content> has better outcomes over <jats:styled-content style=\"fixed-case\">WT<\/jats:styled-content> for reducing splenic complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.569","type":"journal-article","created":{"date-parts":[[2018,6,26]],"date-time":"2018-06-26T09:39:19Z","timestamp":1530005959000},"page":"476-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"25","author":[{"given":"Kohei","family":"Nakata","sequence":"first","affiliation":[{"name":"Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Shikata","sequence":"additional","affiliation":[{"name":"Mie Prefectural Ichishi Hospital Tsu\u2010Shi Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Ohtsuka","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Ukai","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Mie University School of Medicine Tsu Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Miyasaka","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria Vanessa D. M.","family":"Velasquez","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Gotoh","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Ban","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Hepato\u2010Biliary\u2010Pancreatic Surgery Nippon Medical School Tokyo 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