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Updated: Jul 14, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Preservative spleen surgery and hyperbaric oxygen therapy
Isabel Cristina Andreatta Lemos Paulo1, Danilo Nagib Salomão Paulo, Luiz Cálice Cintra
1Laboratory of the Division of Surgical Principles, Derpartment of Surgery, School of Science, Santa Casa de Misericordia, 29042-753 Vitória, ES, Brazil. icpaulo@unimedvitoria.com.br
Purpose:
To assess functional and morphological aspects of spleen auto-implants and of the splenic inferior pole of rats, post-operatively treated or not with hyperbaric oxygen, as well as the survival of these animals, were studied.
Methods:
Seventy-eight male Wistar rats, weighing between 192 and 283 g ( 238,3 +/- 9,6g), were randomly distributed into three groups: Group 1--(n=20), spleen manipulation; group 2--(n=36), spleen auto-implantation; group 3--(n= 22), subtotal splenectomy preserving the inferior pole. Each group was subdivided as follows: subgroup a, not submitted to hyperbaric oxygen therapy: 1a(n=10), 2a(n=21), 3a(n= 13); subgroup b, submitted to the therapy: 1b(n=10), 2b(n=15), 3b(n=9). Blood was collected pre-operatively and 11 days after surgery, for the estimation of lipids and immunoglobulins and the counting of platelets and Howell-Jolly corpuscles. The spleen and remains were taken for histological study.
Results:
The number of surviving animals was significantly higher in groups 1(p<0,01) and 3(p<0,05) relative to those of subgroup 2a. Total cholesterol and the LDL fraction increased significantly in subgroup 2a (p<0,01) and 3a (p<0,05), and remained unaltered in subgroups 2b e 3b. IgM decreased more significantly in subgroup 2 than in subgroup 3 (p<0,001 vs p<0,01). The increase of platelet numbers and the appearance of Howell Jolly corpuscles was smaller in subgroup 2b compared to subgroup 2a , and in group 3 compared to group aqui-> 2. The macro and microscopic appearance in subgroup 2b were more viable than in subgroup 2a, and that of group 3 more viable than in group 2. The survival of the animals carrying their whole spleen or its inferior pole was more frequent than that of the auto-implanted animals.
Conclusion:
Functionality and viability of the whole spleen or of its inferior pole, were better than in the auto-implanted animals. Hyperbaric oxygen-therapy contributed to increased survival frequency of auto-implanted animals, and to improve the functionality and viability of the auto-implants and the function of the inferior splenic pole, and did not interfere in animals carrying their whole spleen.
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Assessment:
1. Clinical Evaluation:
History: