Background : For splenectomized patients, weakened immune system throughout the lifetime causing life-threatening infection such as overwhelming post-splenectomy infection(OPSI) is an important issue. Although it is highly recommended that vaccination for encapsulated bacteria should be done at least two weeks prior to splenectomy, it is difficult for patients to adhere on recommendations. We aimed to investigate the impact of timing of vaccination on post-splenectomy infection rate after distal pancreatectomy and splenectomy.

Methods : Patients who underwent minimally invasive distal pancreatectomy in Asan medical center between 2005 and 2019 were included in this study. Post-splenectomy infection was defined as an episode of infection requiring admission to hospital with intravenous antibiotics administration and OPSI as requiring ICU admission.

Results : A total of 1196 patients underwent distal pancreatectomy with splenectomy and 175 patients who did not get the vaccinations were excluded from the study. Among 1021 patients who were vaccinated, 131 patients(12.8%) were vaccinated prior to surgery and 890 patients(87.2%) after surgery. 879 patients(86.1%) received pneumococcal vaccine, 698 patients(68.4%) received meningococcal vaccine, 837 patients(82.0%) received Hib vaccine respectively, and 676 patients(66.2%) had all three vaccines covered. In the preoperative vaccination group, 5 patients(3.8%) had infection while 37 patients(4.2%) had infection in the post-operative group insisting no significant difference between groups(p=0.999). There was 1 case of OPSI in the post-operative vaccination group.

Conclusions : Despite the recommendations to receive vaccinations before splenectomy, patients who received vaccination after surgery showed comparable infection rate. Therefore, timing of vaccinations did not affect the post-splenectomy infection rate.