Laparoscopic management of non-parasitic splenic cysts

Non-parasitic cysts are an infrequent disease of the spleen. Most likely congenital in their origin, epithelial splenic cysts require surgical treatment if enlarged or symptomatic. The aim of this study was to assess the impact of the laparoscopic technique in the management of splenomegaly due to cystic disease. From July 2001 to September 2002 4 patients underwent laparoscopic splenectomy in our department for symptomatic enlarged non-parasitic splenic cysts. Cystic lesions were evaluated by ultrasonography, CT scan and magnetic resonance of the abdomen. The choice of total laparoscopic splenectomy according to the "hanged spleen" procedure was conditioned by the technical difficulty of performing conservative treatment due to the site of the upper pole of the enlarged lesions, adherent to the diaphragm in 3 cases, and by the presence of multiple trabeculated splenic cysts in 1 case. Laparoscopy was always completed and all patients obtained relief of their symptoms. When conservative treatment such as partial splenectomy or decapsulation may jeopardize the good outcome of the operation, the management of nonparasitic splenic cysts can be successfully achieved by total laparoscopic splenectomy.