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Updated: Jun 27, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
Observation for nonoperative management of the spleen: how long is long enough?
Victor W McCray1, James W Davis, Deborah Lemaster
1Department of Surgery, UCSF-Fresno, Community Regional Medical Center, Fresno, California 93721, USA. vmccray@fresno.ucsf.edu
Background:
Nonoperative management of splenic injury is common with reported success rates between 83% and 97%. However, there are no specific protocols for nonoperative observation published in the literature. The purpose of this study is to analyze the safety and effectiveness of our institutional guideline for observation of patients managed nonoperatively for splenic injury.
Methods:
A retrospective registry and chart review was conducted for all patients with splenic injury who were admitted for nonoperative management (NOM). Our guideline for observation is admission with bed rest, serial hemoglobins every 6 hour, and discharge when hemoglobin is stable. Data collected for this study was age, gender, Injury Severity Score, grade of splenic injury, length of stay, NOM failures while in hospital and readmissions after discharge for nonoperative failure.
Results:
From August 2002 through June 2007, 449 patients were admitted for NOM of splenic injury. Sixteen (4%) patients failed NOM and went to the operating room for splenectomy.
Conclusions:
NOM of blunt splenic injuries had a 96% success rate following our protocol. The guideline successfully identified all the patients failing NOM during the inpatient observation period with the exception of one patient that was noncompliant to protocol. This guideline for observation is safe and effective.
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