Feasibility and Safety of Laparoscopic Partial Splenectomy: A Case Series

Total splenectomy is associated with infectious and thrombotic complications; thus, partial splenectomy has emerged as a spleen-preserving alternative. However, despite reports of advantageous perioperative outcomes with total splenectomy, the feasibility and safety of laparoscopic partial splenectomy (LPS) in adults remain insufficiently established.

We retrospectively analyzed six consecutive adult patients undergoing LPS for splenic neoplasms and a cyst. Preoperative 3D-CT was used to evaluate hilar vascular anatomy and plan resection.

No cases required conversion to open surgery or total splenectomy, and no blood transfusions were needed. The mean postoperative hospital stay was 6.2 days; no postoperative infectious complications, splenic or portal vein thrombosis, or splenosis were observed. The preoperative splenic volume ranged from 59-1204 mL, with 2-4 arterial branches, and the median tumor size was 35.5 mm. The remnant splenic volume ranged from 18-524 mL. In all evaluable cases, tumors were included within the ischemic demarcation area after division of feeding arteries, and postoperative imaging correlated well with the predicted remnant arterial supply.

LPS is a safe and feasible procedure that preserves splenic function and allows for preoperative planning.