Laparoscopic splenectomy after arterial embolisation.
Laparoscopic splenectomy remains a challenging procedure, as haemorrhage causes the most complications. In order to reduce this risk, preoperative selective embolisation of the splicing artery has been performed in a series of six successful laparoscopic splenectomies in one male and five female patients with a mean age of 34.6 years (range 17-53 yrs). Indications for surgery were immune thrombocytopenic purpura (ITP)(n = 3), non-Hodgkin lymphoma with secondary haemolytic anaemia (n = 1), autoimmune haemolytic anaemia (n = 1) and congenital spherocytosis (n = 1). The mean splenic length was 12.3 cm (range 9-16 cm) and no accessory spleens were identified. Mean operative time was 96.7 min (range 90-150 min). There were no deaths nor haemorrhagic or septic complications. Recovery after surgery was excellent with a mean hospital stay of 5.2 days (range 2-10 days). We conclude that selective embolisation of the splenic artery, just prior to laparoscopic splenectomy adds to the safety, and operating time may be shortened.
Academic Surgical Center, Stuivenberg, Antwerpen, Belgium.
E
E
Totte
R
R
Van Hee
I
I
Kloeck
L
L
Hendrickx
P
P
Zachee
P
P
Bracke
P
P
Hermans
D000293:Adolescent; D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome