Consequences of splenectomy in pancreatic surgery: should we really plan a prophylactic strategy for splenectomized patients?

Surgeons facing with benign, premalignant and malignant tumors of the body and the tail of pancreas utilize distal pancreatectomy that is worldwide considered to be a standardized procedure. Traditionally, this operation includes en-bloc splenectomy. As an alternative, a spleen-preserving distal pancreatectomy may be performed through conservation of the splenic artery and vein by ligating the pancreatic tributaries or through the Warshaw’s technique which includes perfusion of the spleen by the short gastric vessels [1]. Both techniques are feasible with minimally invasive approaches, which are well described and safe to perform [2, 3]. Because of some important functions of the spleen such as immunological defenses, hypercoagulability and hematological malignancies after splenectomy, several authors [4, 5, 6] have recently pointed out the benefits in the long run of splenic preservation in distal pancreatectomy when compared with splenectomized patients.