Splenectomy and tumor size are risk factors for serious perioperative morbidity of laparoscopic distal pancreatectomies

IntroductionThe determinants influencing the risk for complications of laparoscopic distal pancreatectomies (LDP) are not yet fully defined, thus we aimed to determine risk factors for serious perioperative morbidity after LDP with spleen preservation, LDP and radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas (RAMPS).Material and methodsRetrospective cohort study of consecutive patients that underwent LDP between January 2019 and December 2022. Study group included patients with serious perioperative morbidity (III – V grades in Clavien-Dindo classification) during 30-days period after operation. Control group consisted of patients without serious perioperative morbidity. 142 patients were included into the following study.ResultsSerious perioperative morbidity occurred in 33 (23.24%) operated patients, while mortality included 3 cases (2.11%). 9/68 (13.2%) patients had serious perioperative morbidity after LDP with spleen preservation (27.3% of perioperative morbidity group). 13/51 patients, i. e. 25.5%, after LDP with splenectomy included in perioperative morbidity group (39.4%). 11 out of 23 patients (47.8%) had serious perioperative morbidity after RAMPS (33.3% of perioperative morbidity group). In multivariate logistic regression need for splenectomy during pancreatectomy (OR 3.66, 95%CI 1.20-11.18) and tumor above 28 millimeters in size (OR 3.01, 95%CI 1.19-9.59) were independent risk factors for serious perioperative morbidity.ConclusionNeed for splenectomy during laparoscopic distal pancreatectomy and tumor size above 28 millimeters were independent risk factors for serious perioperative morbidity after laparoscopic distal pancreatectomies.