Spleen Preservation During Pancreatectomy: When Is Splenectomy Needed?

The spleen is routinely preserved during pancreatectomy (distal, total, or Whipple).

Splenectomy indicated only if:

• Direct tumor involvement (splenic hilar nodes, pancreatic tail cancer).
• Vascular compromise (splenic artery/vein encasement).
• Trauma/ischemia during dissection.

Preservation avoids overwhelming post-splenectomy infection (OPSI) risk and preserves immune function.