A ten-year experience with laparoscopic treatment of splenic cysts.
OBJECTIVE
The management of symptomatic splenic cysts lacks clear, evidence-based guidelines due to its low incidence. Recently, laparoscopic treatment has been described. We present our experience with the laparoscopic management of solitary splenic cysts with a review of the existing literature, and recommendations for therapy.


METHODS
All patients who underwent laparoscopic treatment of splenic cysts over a 10-year period were identified. The medical records of these 9 patients were reviewed.


RESULTS
All surgeries were performed laparoscopically, with no conversions. Two patients underwent cyst decapsulation, and 7 patients underwent cyst unroofing. No major complications occurred. Recurrence occurred in 33.3% of patients; unroofing had a recurrence rate of 42.9% compared with 0% after decapsulation. Pseudocysts were found in 66.7% of patients and true cysts on final pathology were found in 33.3%.


CONCLUSIONS
Laparoscopic decapsulation and unroofing of splenic cysts are safe procedures that confer the advantages of both splenic preservation and minimally invasive surgery. Cyst unroofing has a high recurrence and should be selectively used. Laparoscopic cyst decapsulation is associated with longer operative time, but should be considered as first-line therapy.
Chin
Edward H
EH
Department of Surgery, Mount Sinai School of Medicine, New York, New York 10029, USA. edward.chin@mountsinai.org
Shapiro
Ron
R
Hazzan
David
D
Katz
L Brian
LB
Salky
Barry
B
D000328:Adult; D003560:Cysts / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D013158:Splenic Diseases / Q000601:surgery*