title: [Management of splenectomized patients].
abstract: PARTIAL SPLENECTOMY: Partial resection is possible in certain indications for splenectomy. Partial splenectomy is the best way to prevent postsplenectomy infections, even though vaccination and antibiotic prophylaxis must be prescribed. This association is also necessary when the patient undergoes an autograft to reimplant splenic tissue or develops splenosis, i.e. fortuitous autotransplantation of splenic parenchyma. GUIDELINES FOR PLANNED SPLENECTOMY: Prophylactic vaccination should be performed 15 days, or 6 weeks, before surgery. Antibiotic prophylaxis includes a preoperative injection of cefazolin followed by intravenous amoxicillin, then Oracilline (Penicilline V) with resumption of oral intake. SURGICAL ASPECTS: Indications for laparoscopic surgery have broadened, laparotomy being reserved for the most difficult cases. Special care is recommended concerning complications, particularly respiratory disorders (pleural effusion, atelectasia) and acute pancreatitis.
authors: CHU Lille (59).
authors: J P
authors: JP
authors: Chambon
authors: B
authors: B
authors: Vallet
authors: R
authors: R
authors: Caiazzo
authors: P
authors: P
authors: Zerbib
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000517:prevention & control; D001428:Bacterial Vaccines / Q000008:administration & dosage; D002437:Cefazolin / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D010535:Laparoscopy; D007813:Laparotomy; D010404:Penicillin V / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications; D012307:Risk Factors; D013154:Spleen / Q000637:transplantation; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods; D017890:Splenosis / Q000209:etiology; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines; D000658:Amoxicillin; D002437:Cefazolin; D010404:Penicillin V