To compare the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy between Kimura technique and Warshaw technique.

Literature before August 1, 2018 were reviewed from PubMed, EMBASE, CNKI and Wanfang database by using the keywords laparoscopic, pancreatectomy, pancreatic neoplasms, spleen, Kimura and Warshaw in both English and Chinese. Data about operation time, intraoperative blood loss, total incidence of complications, pancreatic fistula, splenic infarction and length of hospital stay were extracted and subjected to Meta-analysis.

A total of 801 patients were enrolled from 12 articles, including 514 cases treated with Kimura technique and 287 cases with Warshaw technique. Meta-analysis revealed that the incidence of postoperative splenic infarction of Kimura technique was significantly lower than that of Warshaw technique (OR=0.13, 95%CI: 0.08-0.23; P<0.05). No significant difference was observed in the length of hospital stay, intraoperative blood loss and operation time between two techniques (SMD=0.31, -0.12, -0.05; P>0.05). And no significant difference was observed in the total incidence of postoperative complications and incidence of pancreatic fistula between two techniques (OR=0.65, 0.87; P>0.05).

The incidence of postoperative splenic infarction in patients using Kimura technique is lower compared with those using Warshaw technique. Kimura technique is better than Warshaw technique for laparoscopic spleen-preserving pancreatectomy, which can be the primary choice for operation.

Pancreatic neoplasms; Laparoscopes; Pancreatectomy; Meta-analysis; Kimura; Warshaw