Demeure M J, Frantzides C T
Department of Surgery, Medical College of Wisconsin.
WMJ. 1998 Nov;97(10):33-4.
Laparoscopic splenectomy is an example of the recent continued advancement in laparoscopic surgery as techniques are adapted for procedures previously done only via a laparotomy.
We analyzed our initial experience with laparoscopic splenectomy for details of the operative procedure and the clinical outcome including length of stay and complication rates.
Two surgeons performed 11 laparoscopic splenectomies for cancer or hematologic disorders. In two instances (18%) conversion to open splenectomy was necessary due to bleeding at the splenic hilum. There were no mortalities. Two patients developed pancreatic fluid collections that were successfully drained percutaneously. The seven patients who had an uncomplicated course resumed eating a regular diet in 2.0 +/- 0.6 days (mu +/- SD) and had a hospital stay of 2.7 +/- 1.1 days. Hospital stay was significantly longer for the patients who had complications 9.7 +/- 7.2 days (p < 0.05) and for the 11 patients undergoing on elective uncomplicated open splenectomy during the same time period, 6.5 +/- 2.0 days (p < 0.05). For the 9 patients who had a completed laparoscopic splenectomy, the mean operative blood loss was 263.9 +/- 241.4 cc. The mean operative time was 293.3 +/- 91.4 minutes. The spleens removed laparoscopically weighed an average of 390 grams (range 17 to 1584 grams).
Laparoscopic splenectomy can be performed safely and is associated with a rapid resumption of oral alimentation and shortened hospital stay compared to open splenectomy. Complications experienced in our early experience included conversion to open splenectomy and fluid collections from pancreatic leakage.
