Staple line bleeding following laparoscopic splenectomy: intraoperative prevention and postoperative management with splenic artery embolization.
Laparoscopic splenectomy (LS) has become the procedure of choice for a variety of hematologic disorders and non-traumatic splenic pathology. Perioperative hemorrhage remains one of the most feared complications. We report 2 cases of postoperative splenic artery hemorrhage following vascular division using 2.5-mm Endo-GIA stapling cartridges. In this paper we identify and discuss important technical aspects of obtaining hilar vascular control during LS and report the first use of postoperative splenic artery embolization to control staple line bleeding following LS.
Kercher
Kent W
KW
Department of Surgery, University of Massachusetts Medical School, Worcester, MA 01655, USA. novitsky@ummhc.org
Novitsky
Yuri W
YW
Czerniach
Donald R
DR
Litwin
Demetrius E M
DE
D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D011184:Postoperative Period; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods; D013157:Splenic Artery; D013163:Splenomegaly / Q000601:surgery; D017792:Surgical Stapling / Q000009:adverse effects*; D016896:Treatment Outcome