Laparoscopic splenectomy:: 7-year experience

Background: Laparoscopic splenectomy is an effective and safe technique in the management of benign splenic pathologies. Methods: We reviewed our 7-year experience to evaluate utility and safety of this procedure. Results: Laparoscopic splenectomy was performed in 20 patients (13 women, 7 men), with a mean age of 49 years. Pathology included 19 cases of idiopathic thrombocytopenic purpura (ITP) and one case of autoimmune hemolytic anemia. Mean operative time was 165 min, including anesthesic procedure. There was only one conversion to open surgery. Accessory spleens were detected in 15% of patients. Early remission of hematological disorders was achieved in 70% of the cases and long-term remission in 90%. The complication rate was 20%, including two cases of subphrenic hematoma, one case of acute focal pancreatitis and one case of thrombosis of the portal venous system; all recovered with no sequelae. Mortality rate was 0%. Conclusions: Laparoscopic splenectomy obtains results identical to those of open surgery in terms of efficacy and safety but with the benefits of laparoscopic surgery. Therefore, it should be considered as the procedure of choice for the treatment of benign hematological pathologies unresponsive to medical therapy.