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Open partial splenectomy operative techniques and follow-up – A case series from a tertiary care centre in South India

Rajeevan Philip Sridhar, Titus D K, Gilbert Samuel Jebakumar, Beulah Roopavathana, Suchita Chase.


Abstract

Introduction: Spleen-preserving surgical techniques have become increasingly common to avoid the fatal peri-operative and long-term complications following total splenectomy including OPSI. Immune functions of the spleen are better preserved after partial splenectomy. In this case series, we describe the operative techniques and follow-up of four patients who underwent open partial splenectomy for benign aetiology.

Case Series: Four patients underwent partial splenectomy for benign aetiology. Left subcostal or Midline laparotomy incision was chosen. After temporary clamping of splenic vessels, LigaSure™ was used for sectioning splenic parenchyma and Surgicel®Fibrillar™ or pledged sutures were used to achieve haemostasis. Omentoplasty was done additionally and remnant spleen was anchored to abdomen wall to prevent torsion. All patients are on follow-up and have not developed OPSI.

Conclusion: Partial splenectomy is a safer and feasible surgical alternative for total splenectomy when indicated for benign aetiology and appears to be protective against OPSI. A good understanding of vascular anatomy and operative techniques for partial splenectomy is an essential part of any general surgeon’s armamentarium.

Key words: Partial splenectomy, Overwhelming post-splenectomy infection, Spleen preserving surgery, Splenic cyst






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