title: Laparoscopic management of giant splenic true cyst with partial splenectomy: a case report.
abstract: Non-parasitic splenic cysts are relatively rare, and the optimal surgical treatment for them remains controversial. Laparoscopic unroofing is a relatively safe and easy technique, but a significant number of recurrences has been reported. Thus, complete cystectomy with partial splenectomy is recommended by several surgeons. However, patients sometimes suffer from intraoperative bleeding. Here, we report a patient with a giant non-parasitic splenic cyst who underwent subtotal cystectomy with partial splenectomy. After the dissection of the vessels circulating the upper pole at the splenic hilum, the resection line of the splenic parenchyma was on the ischemic side of the cyanotic demarcation line. A vessel sealing system and laparoscopic coagulation shears were used for the resection. We intentionally left about 10% of the cyst wall to avoid bleeding from the non-ischemic splenic parenchyma and remaining vessels. No recurrence has been detected after 6 months of observation. We believe this method could be a useful alternative procedure for the treatment of non-parasitic splenic cysts and preservation of the splenic parenchyma.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishnomiya, Japan. fujimoto-tky@umin.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iimuro
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Okada
authors.forename: Hideaki
authors.initials: H
authors.lastname: Sueoka
authors.forename: Seikan
authors.initials: S
authors.lastname: Hai
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kondo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzumura
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
mesh_terms: D003560:Cysts / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D013156:Splenectomy; D013158:Splenic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: Non-parasitic splenic cysts; partial splenectomy; subtotal cystectomy