Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2018; 10(8): 84-89
Published online Nov 27, 2018. doi: 10.4240/wjgs.v10.i8.84
Male gender and increased body mass index independently predicts clinically relevant morbidity after spleen-preserving distal pancreatectomy
Traian Dumitrascu, Mihai Eftimie, Andra Aiordachioae, Cezar Stroescu, Simona Dima, Mihnea Ionescu, Irinel Popescu
Traian Dumitrascu, Mihai Eftimie, Andra Aiordachioae, Cezar Stroescu, Simona Dima, Mihnea Ionescu, Irinel Popescu, Department of General Surgery and Liver Transplant, Fundeni Clinical Institute, Bucharest 022328, Romania
Author contributions: All authors helped to perform the research and to write the manuscript; Dumitrascu T, Aiordachioae A, Eftimie M and Dima S contributed to drafting conception and design; Dumitrascu T and Aiordachioae A contributed to data analysis; Dumitrascu T, Stroescu C, Ionescu M and Popescu I contributed to performing procedures.
Institutional review board statement: This study was retrospective, and no interference with patients’ treatment was made. Thus, the approval by the Ethics Committee of the Fundeni Clinical Institute was waived.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous retrospective clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Traian Dumitrascu, MD, PhD, Senior Lecturer, Department of General Surgery and Liver Transplant, Fundeni Clinical Institute, Fundeni Street no 258, Bucharest 022328, Romania. traian.dumitrascu@umfcd.ro
Telephone: +40-21-3180417 Fax: +40-21-3180417
Received: August 1, 2018
Peer-review started: August 1, 2018
First decision: August 24, 2018
Revised: September 24, 2018
Accepted: November 4, 2018
Article in press: November 4, 2018
Published online: November 27, 2018
ARTICLE HIGHLIGHTS
Research background

Many studies have explored potential predictors of morbidity after distal pancreatectomy. All the reported studies included both patients with and without spleen preservation. Some studies have suggested that there might be some differences in outcomes between the patients with distal pancreatectomy, with and without spleen preservation. To date, there is no study to explore potential predictors of postoperative morbidity in a group of patients with only spleen-preserving distal pancreatectomy. The aim of the study is to identify risk factors for clinically relevant morbidity after spleen-preserving distal pancreatectomy in a single surgical center experience.

Research motivation

Morbidity after spleen-preserving distal pancreatectomy remains a significant concern and preservation of the spleen during distal pancreatectomy might sometimes be technically challenging. Thus, identification of potential predictors of clinically relevant morbidity in patients with spleen-preserving distal pancreatectomy would be of interest for clinical practice to better select the patients for this type of surgical procedure.

Research objectives

The primary objective of the study was to explore potential predictors of clinically relevant morbidity after spleen-preserving distal pancreatectomy in a single surgical center experience.

Research methods

It was a retrospective analysis reviewing the data of 41 consecutive patients who underwent spleen-preserving distal pancreatectomy with spleen vessel preservation between 2000 and 2015 in our Department of Surgery. Appropriate statistical tests were used to compare potential risk factors between the groups of patients with and without clinically relevant morbidity after spleen-preserving distal pancreatectomy, in uni- and multivariate analyses.

Research results

To the best of our knowledge, this is the first study exploring potential predictors of clinically relevant morbidity in patients with spleen-preserving distal pancreatectomy. The study found male gender and increased body mass index as independent predictors of clinically relevant morbidity after spleen-preserving distal pancreatectomy.

Research conclusions

This is the first study that identifies male gender and increased body mass index as risk factors of clinically relevant morbidity in a group of patients with only spleen-preserving distal pancreatectomy. Patient-related factors such as gender and body mass index should be taken into consideration when a spleen-preserving distal pancreatectomy is proposed. The data provided in the present study can be used for clinical decision-making, particularly when preservation of the spleen during distal pancreatectomy is technically demanding.

Research perspectives

Preoperative evaluation of patients suitable for a spleen-preserving distal pancreatectomy is of utmost importance. The impact of male gender and body mass index on postoperative outcome after spleen-preserving distal pancreatectomy remains to be explored in future studies including more substantial number of patients.