Laparoscopic splenectomy for a huge splenic cyst without preoperative drainage: report of a case

Laparoscopic splenectomy currently is a safe procedure and offers better cosmetic results, less pain, and a shorter hospital stay than the traditional open procedure. However, there have been only a few reports of laparoscopic removal of giant splenic cysts. An 18-year-old woman was admitted with abdominal fullness. CT scans and MRI images of the upper abdomen revealed a cystic mass having a diameter of 19 cm. Preoperative diagnosis was a large splenic cyst, and laparoscopic splenectomy with intraoperative cyst drainage (amount of drained fluid: 3,000 mL) was performed. Histologically, almost the entire cyst wall was lined with fibrous tissue, but a small portion was covered with stratified squamous epithelium. The final diagnosis was epidermoid cyst. The postoperative course was uneventful. Laparoscopic splenectomy should be tried first even in patients with a huge cyst, and intraoperative drainage under laparoscopic guidance facilitates laparoscopic splenectomy.