New sights of spleen-preserving versus splenectomy in distal pancreatectomy for pancreatic neuroendocrine tumors: a systematic review and meta-analysis
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By
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April 16, 2026
Objective:
To compare the perioperative outcomes of spleen-sparing distal pancreatectomy (SPDP) versus distal pancreatectomy with splenectomy (DPS) for patients with pancreatic neuroendocrine tumors (pNETs), highlighting the significance of this comparison.
Key Findings:
- SPDP resulted in less intraoperative blood loss compared to DPS (SMD, -0.50, 95% CI [-0.90 to -0.11]).
- Fewer lymph nodes were examined in the SPDP group (MD, -3.30, 95% CI [-5.35 to -1.24]).
- SPDP had a shorter operative time (MD, -31.78 min, 95% CI [-57.98 to -5.58]).
- SPDP showed fewer postoperative major complications (OR, 0.57, 95% CI [0.34 to 0.95]) and lower transfusion rates (OR, 0.25, 95% CI [0.07 to 0.83]).
- SPDP patients had a shorter hospital stay (MD, -1.13 days, 95% CI [-2.02 to -0.24]).
- No significant differences were found in R0 resection or lymph node metastasis between the two groups.
Interpretation:
SPDP may be a feasible option for selected patients with small, well-differentiated G1/G2 pNETs, potentially reducing surgical risks, but further studies are essential to confirm these findings.
Limitations:
- The analysis is based on retrospective studies, which may introduce bias and affect the reliability of the results.
- The sample size is limited to 457 patients across four studies, which may not represent the broader population.
- Further high-quality studies are needed to validate findings and refine patient selection criteria.
Conclusion:
SPDP may provide benefits in managing small, well-differentiated pNETs, warranting further investigation to confirm its efficacy and safety.
