Should repeated partial splenectomy be attempted in patients with hematological diseases? Technical pitfalls and causes of failure in Gaucher's disease.
OBJECTIVE
The awareness of the risk of overwhelming sepsis after splenectomy prompted surgeons to attempt splenic preservation in patients who had hematologic diseases for which splenectomy was the conventional treatment. Partial splenectomy for Gaucher's disease was widely performed before the introduction of alglucerase. In sporadic cases a second partial splenectomy had also been attempted.


METHODS
The authors present three cases of failed repeated partial splenectomy attempted before alglucerase was available. The role of angiography in planning operative strategy and the surgical pitfalls of this unusual reintervention are discussed.


CONCLUSIONS
New indications for partial splenectomy in other hematologic diseases makes the experience gained with Gaucher's disease valuable for management decisions.
Freud
E
E
Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Beilinson Medical Campus, Petah Tiqva.
Cohen
I J
IJ
Neuman
M
M
Mor
C
C
Zer
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005776:Gaucher Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D005962:Glucosylceramidase / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018579:Patient Selection; D011859:Radiography; D012086:Reoperation; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods; D013163:Splenomegaly; D017211:Treatment Failure
C070292:alglucerase; D005962:Glucosylceramidase