Early Experience with Laparoscopic Splenectomy in Benign Splenic Disorders

Abstract

Background: Laparoscopic splenectomy is evolving procedure and is now considered the procedure of choice in elective splenectomy by many centers, but technically demanding especially in large sized ones. Our aim was to evaluate the outcome of laparoscopic splenectomy for a variety of benign splenic disorders in our early experience. Patients and Methods: This prospective study was carried out on twenty-two patients treated with laparoscopic splenectomy in Tanta University Hospital from January 2014 to January 2016. Patients chart review including patient characteristics, splenic pathology, intraoperative difficulties or complications and postoperative outcome. Follow up ranged from 6 months to 2 years with a mean of 20 months. Results: Age of patients ranged from fifteen to fifty-nine years with a mean of 41.7 years. Fourteen cases (63%) with idiopathic thrombocytopenic purpura (ITP), six cases (27.3%) with hypersplenism and two cases (9.1%) with autoimmune hemolytic anemia. Accessory spleens were found in six patients (27.3%) and removed. Mean operative time was 120±15 minutes. Intraoperative bleeding occurred in six cases (27.3%), laparoscopic control attempted and succeeded in four of them, but conversion was inevitable in two cases (9.1%). There were no major postoperative complications or deaths. Conclusion: Laparoscopic splenectomy is not only safe minimal invasive procedure, with comparable results of the open splenectomy in management of small and medium sized spleens but also, has the advantages of negligible intraoperative blood loss. Larger series with longer periods of follow up are required to evaluate this promising operation.