Distal pancreatectomy(DP) is associated with high morbidity. In clinical practice, postoperative white blood cell(WBC) counts are useful indicators of infection complications. The aim of this study was to determine the relevance of extremely high postoperative day (POD)1 WBC counts after DP and their relationship to perioperative outcomes. Methods

From December 2005 to December 2016, data from patients who had open or minimally invasive DP surgery (robot or laparoscopy, MIS) for benign or borderline malignant tumors were retrospectively reviewed. Patients were divided into groups based on POD1 WBC count (>20K, High and <20K, Low) for comparisons. Results

Twelve patients (4.6%) were categorized into the High group. There were significant differences in age ( p =0.019), BMI ( p =0.010), and spleen-preserving rate ( p =0.002) between the High and Low groups. In binary logistic regression analysis, the risk factors for severe complication was age ( p =0.032) and open DP ( p =0.005), not POD1 WBC count. Conclusions

Extremely high WBC count after POD1 after DP was not associated with severe complications, but was associated with splenectomy. Surgical methods and age were associated with severe complications.