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Comparative Analysis of Outcomes of Distal Pancreatectomy with or without Splenectomy Using the National Inpatient Sample

Hassan Aziz, Mazhar Khalil, Bellal Joseph, Evan Ong, Taylor S Riall, Tun Jie

Background Recent literature has advocated splenic preservation during distal pancreatectomy. However, no national analysis to date assessed the differences in outcomes between patients who underwent distal pancreatectomy with a concomitant splenectomy and patients who underwent distal pancreatectomy with a splenic preservation. Materials and Methods We performed a retrospective analysis of Nationwide Inpatient Sample database of patients who underwent distal pancreatectomy from 2004 until 2011(8 years). Patients were categorized into two groups: Distal pancreatectomy with splenectomy and distal pancreatectomy with splenic preservation. Results A total of 10,925 patients underwent distal pancreatectomy over the 8-year study period. 76.4% (n = 8,352) of the patients underwent Distal pancreatectomy with splenectomy. On multivariate regression analysis, age (OR [95%CI]: 1.02 [1.1-1.2]), female gender (OR [95%CI]: 1.8 [1.2-2.7]), malignant disease (OR [95%CI]: 1.8[1.0-3.05]), and weekend admission (OR [95% CI]: 3.7[2.3-6.1]) were predictors of mortality. Teaching status of the hospital (OR [95%CI]: 0.6 [0.4-0.9]) and distal pancreatectomy with splenectomy (OR [95%CI]: 0.5 [0.3- 0.8]) were associated with decreased odds of mortality. Conclusion In this nationwide database analysis, distal pancreatectomy with splenic preservation was found to be independently associated with higher mortality rates when compared to distal pancreatectomy with splenectomy.