Open partial splenectomy operative techniques and follow-up A case series from a tertiary care centre in South IndiaRajeevan Philip Sridhar, Titus D K, Gilbert Samuel Jebakumar, Beulah Roopavathana, Suchita Chase.
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 surgeons armamentarium.
Key words: Partial splenectomy, Overwhelming post-splenectomy infection, Spleen preserving surgery, Splenic cyst