Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study

Abstract This study compared the lateral approach laparoscopic spleen-preserving distal pancreatectomy (LA LSPDP) with the conventional approach to LSPDP (CA LSPDP) for benign to borderline malignant tumors in the pancreatic tail. A multicenter retrospective cohort of patients undergoing LA LSPDP or...

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Main Authors: Sung Eun Park, Tae Yoon Lee, Young Chul Yoon, Chang Ho Seo, Gun Hyung Na, Yun Kyoung Woo, Dong Do You, Tae Ho Hong
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-10997-w
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author Sung Eun Park
Tae Yoon Lee
Young Chul Yoon
Chang Ho Seo
Gun Hyung Na
Yun Kyoung Woo
Dong Do You
Tae Ho Hong
author_facet Sung Eun Park
Tae Yoon Lee
Young Chul Yoon
Chang Ho Seo
Gun Hyung Na
Yun Kyoung Woo
Dong Do You
Tae Ho Hong
author_sort Sung Eun Park
collection DOAJ
description Abstract This study compared the lateral approach laparoscopic spleen-preserving distal pancreatectomy (LA LSPDP) with the conventional approach to LSPDP (CA LSPDP) for benign to borderline malignant tumors in the pancreatic tail. A multicenter retrospective cohort of patients undergoing LA LSPDP or CA LSPDP for pancreatic tail tumors with a tumor center located beyond the left lateral border of the aorta was analyzed. A 1:1 propensity score matching (PSM) yielded 56 patients per group. A total of 172 patients were planned for LSPDP. After PSM, the tumor sizes were comparable (3.1 cm vs 3.3 cm, p = 0.549). However, resected specimens were longer in the CA LSPDP group (8.4 cm vs. 7.7 cm, p < 0.001). Rates of conversion to open surgery, the use of Warshaw’s technique, and the need for combined splenectomy were not significantly different between the two groups. However, the LA LSPDP group had a shorter operation time (127.1 min vs. 161.1 min, p = 0.002) and less blood loss (106.2 cc vs. 291.4 cc, p = 0.001). The postoperative complication rates were similar (35.7% vs. 27.3%, p = 0.339). LA LSPDP is a safe and effective technique that reduces operative time and blood loss in pancreatic tail tumors; however, larger prospective studies are needed to confirm this finding.
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spelling doaj-art-d6ee2bf9274e488483b3e54d880f506c2025-08-20T04:01:51ZengNature PortfolioScientific Reports2045-23222025-08-011511810.1038/s41598-025-10997-wEfficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort studySung Eun Park0Tae Yoon Lee1Young Chul Yoon2Chang Ho Seo3Gun Hyung Na4Yun Kyoung Woo5Dong Do You6Tae Ho Hong7Department of Hepato-Biliary and Pancreas Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Hepato-Biliary and Pancreas Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract This study compared the lateral approach laparoscopic spleen-preserving distal pancreatectomy (LA LSPDP) with the conventional approach to LSPDP (CA LSPDP) for benign to borderline malignant tumors in the pancreatic tail. A multicenter retrospective cohort of patients undergoing LA LSPDP or CA LSPDP for pancreatic tail tumors with a tumor center located beyond the left lateral border of the aorta was analyzed. A 1:1 propensity score matching (PSM) yielded 56 patients per group. A total of 172 patients were planned for LSPDP. After PSM, the tumor sizes were comparable (3.1 cm vs 3.3 cm, p = 0.549). However, resected specimens were longer in the CA LSPDP group (8.4 cm vs. 7.7 cm, p < 0.001). Rates of conversion to open surgery, the use of Warshaw’s technique, and the need for combined splenectomy were not significantly different between the two groups. However, the LA LSPDP group had a shorter operation time (127.1 min vs. 161.1 min, p = 0.002) and less blood loss (106.2 cc vs. 291.4 cc, p = 0.001). The postoperative complication rates were similar (35.7% vs. 27.3%, p = 0.339). LA LSPDP is a safe and effective technique that reduces operative time and blood loss in pancreatic tail tumors; however, larger prospective studies are needed to confirm this finding.https://doi.org/10.1038/s41598-025-10997-wLaparoscopyDistal pancreatectomySplenic vessel preservationLeft lateral approachPancreatic neoplasms
spellingShingle Sung Eun Park
Tae Yoon Lee
Young Chul Yoon
Chang Ho Seo
Gun Hyung Na
Yun Kyoung Woo
Dong Do You
Tae Ho Hong
Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study
Scientific Reports
Laparoscopy
Distal pancreatectomy
Splenic vessel preservation
Left lateral approach
Pancreatic neoplasms
title Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study
title_full Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study
title_fullStr Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study
title_full_unstemmed Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study
title_short Efficacy and safety of lateral approach laparoscopic spleen-preserving distal pancreatectomy: a multicenter retrospective cohort study
title_sort efficacy and safety of lateral approach laparoscopic spleen preserving distal pancreatectomy a multicenter retrospective cohort study
topic Laparoscopy
Distal pancreatectomy
Splenic vessel preservation
Left lateral approach
Pancreatic neoplasms
url https://doi.org/10.1038/s41598-025-10997-w
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