search for




 

Partial splenectomy: A case series and systematic review of the literature
Ann Hepatobiliary Pancreat Surg 2018 May;22(2):116-27
Published online May 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Francesco Esposito1, Adele Noviello1, Nicola Moles1, Nicola Cantore2, Mario Baiamonte3, Enrico Coppola Bottazzi1, Antonio Miro1, and Francesco Crafa1

1Department of Oncological and General Surgery, S.G. Moscati Hospital, Avellino, 2Department of Hematology and Stem Cell Transplantation, S.G. Moscati Hospital, Avellino, 3Department of General and Emergency Surgery, Civico Hospital, Palermo, Italy
Received October 29, 2017; Revised December 8, 2017; Accepted December 10, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Partial splenectomy (PS) is a surgical option for splenic mass, in order to reduce postoperative complications and preserve the splenic function. Despite this, data in literature is still scarce. The present study aimed to reveal our recent experience and provide a comprehensive overview of the feasibility and complications related to various surgical approaches. Methods: Data of patients who underwent PS, between 2014 and 2017 were retro-spectively reviewed. Literature was searched for studies reporting all types of PS in adult or adolescent patients. Results: Five PS were performed in our department: two (40%) by laparoscopy and three (60%) by laparotomy. Two (40%) postoperative complications were detected, and in one of them, total splenectomy (TS) by laparotomy was finally required. There were no deaths or complications at last follow-up. Twenty studies including 213 patients were identified in the literature search. The rate of conversion from laparoscopic to open surgery was 3% (range, 5-50%) and in 3% of cases (range, 7-10%) PS was converted into total TS and the overall morbidity rate was 8% (range, 5-25%). In comparison to laparotomy, the conversion rate of laparoscopic approach to TS was 3.5% (vs. 1.4%) and a morbidity rate of 9.8% (vs. 4.3%). Conclusions: The present review shows that PS is a viable procedure in selected cases. The mini-invasive approach seemed to be feasible despite the presence of higher rate of complications than the open technique. In future, further studies on this topic are needed by involving more patients. Furthermore, it is proposed that the development of robotic surgery could make this approach the new gold-standard technique for spleen-preserv-ing surgery. (Ann Hepatobiliary Pancreat Surg 2018;22:116-127)
Keywords : Partial splenectomy; Laparoscopic partial splenectomy; Systematic review