title: Laparoscopic splenectomy for splenic abscess.
abstract: Splenic abscess is a rare clinical entity, and splenectomy remains the treatment of choice. We sought to determine the safety and efficacy of laparoscopic splenectomy in this setting. Using a prospective database of laparoscopic splenectomy, we identified 4 patients who underwent surgery for splenic abscess (3 male, 1 female). Mean age was 55.5 (range 42-78) years. Patient symptoms included: fever and abdominal pain in 4 patients, pleural effusions in 2, and nausea and leukocytosis in 1. Risk factors for splenic abscess included septic emboli from bacterial endocarditis in 2 patients and acquired immune deficiency syndrome in 1. All patients underwent successful laparoscopic splenectomy. Mean operative time was 200 (range 160-220) minutes, and blood loss was 220 (range 100-450) mL. There were no postoperative complications or deaths; postoperative length of stay averaged 14 (range 2-26) days. Despite the difficulty of the operation, the laparoscopic approach appears to be a safe and effective treatment of splenic abscess.
authors.affiliation: Carolinas Laparoscopic and Advanced Surgery Program, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
authors.forename: Alfredo M
authors.initials: AM
authors.lastname: Carbonell
authors.forename: Kent W
authors.initials: KW
authors.lastname: Kercher
authors.forename: Brent D
authors.initials: BD
authors.lastname: Matthews
authors.forename: Charles S
authors.initials: CS
authors.lastname: Joels
authors.forename: Ronald F
authors.initials: RF
authors.lastname: Sing
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D000038:Abscess / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*; D016896:Treatment Outcome