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Laparoscopic splenectomy: outcomes and lessons learned from over 200 cases
A E Park1, G Birgisson, M J Mastrangelo
1Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, KY, USA.
Background:
In this study of laparoscopic splenectomy (LS), we evaluate prospectively gathered perioperative patient data and review lessons learned in the evolution of this procedure.
Methods:
At 2 university medical centers between November 1993 and March 2000, there were 203 patients (122 female patients and 81 male patients) who underwent LS after preoperative evaluation.
Results:
LS was successfully completed in 197 patients (97%). The mean operative time was 145.5 minutes and the length of stay averaged 2.7 days with 143 (70.4%) staying less than 48 hours. The most common indication was idiopathic thrombocytopenic purpura (ITP). Six patients required conversion to open splenectomy (OS), with only 2 conversions in the last 163 cases. No deaths were attributed to the procedure. Complications occurred in 19 patients (9.3%). Thirty accessory spleens were identified in 25 patients (12.3%). Seventeen patients (8.4%) underwent concomitant procedures, most commonly cholecystectomy.
Conclusions:
LS by the lateral approach is both safe and feasible in patients of all ages.