End results of simultaneous pancreatectomy, splenectomy and total gastrectomy for patients with gastric carcinoma.

A distal pancreatectomy is often performed simultaneously with splenectomy and total gastrectomy in the treatment of gastric carcinoma to facilitate dissection of the lymph nodes around the splenic artery. However, the morbidity of partial pancreatectomy is high. Patients undergoing pancreaticosplenectomy in conjunction with total gastrectomy are subject to leaks from the pancreatic stump, which may cause further complications. We performed a retrospective analysis to evaluate the end results of simultaneous distal pancreatectomy with total gastrectomy. The effect of distal pancreatectomy on survival was studied by examination of the records of 174 patients who underwent splenectomy and total gastrectomy for gastric carcinoma. Of these, 93 underwent distal pancreatectomy. Prognostic factors were determined and were examined in relation to the post-operative complications. There was no significant difference in the 5-year survival of the patients who did or did not undergo distal pancreatectomy. There was no correlation between any prognostic factor and distal pancreatectomy. In contrast, distal pancreatectomy was independently associated with post-operative complications. In this retrospective study, the addition of distal pancreatectomy to splenectomy at total gastrectomy for patients with gastric cancer did not affect survival but was associated with severe complications.