Techniques of splenic conservation.

The scope of surgical procedures on the spleen has undergone a dramatic change in the past few years. Efforts directed toward splenic preservation have intensified with the emerging realization that sepsis is a sequela not to be ignored in asplenic subjects. Successful operations on splenic parenchyma require modified techniques of exposure and mobilization of the spleen. The segmental vasculature of the spleen makes possible controlled resection of traumatized or diseased segments of parenchyma. Hemostatic measures include the use of metal clips, ligation of small intrasplenic vessels, and application of topical agents for residual surface bleeding. With the use of such techniques, conservative splenic surgery is possible in minor and major splenic trauma, splenic cysts, and selected pathologic states in the spleen.