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Immunocompetence after incidental splenectomy

H Graffner, P Gullstrand, T Hallberg

    Scandinavian Journal of Haematology
    |May 1, 1982
    PubMed
    Summary
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    Splenectomy during duodenal ulcer surgery led to longer hospital stays and increased lymphocytes, monocytes, and platelets. Further research is needed to understand the impact on T-cell subsets and plasma IgM levels.

    Area of Science:

    • Immunology
    • Gastroenterology
    • Surgical Pathology

    Background:

    • Chronic duodenal ulcers often require surgical intervention.
    • Highly selective vagotomy is a surgical approach for duodenal ulcers.
    • Peroperative complications, such as splenic capsular tears, can necessitate splenectomy.

    Purpose of the Study:

    • To investigate the immunological and hematological consequences of splenectomy in patients undergoing highly selective vagotomy for chronic duodenal ulcers.
    • To compare hematological parameters and lymphocyte subsets between splenectomized and non-splenectomized patients post-surgery.

    Main Methods:

    • A retrospective case-control study matching 12 splenectomized patients with 12 non-splenectomized controls.
    • Analysis of blood counts, lymphocyte subsets (T cells, B cells, Fc IgG receptor-bearing T cells), plasma IgM levels, and complement activation pathways.

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  • A median postoperative follow-up interval of approximately 5 years.

    • Main Results:

    • Splenectomized patients experienced longer hospitalizations.
    • Increased blood counts of lymphocytes, monocytes, and platelets were observed in splenectomized patients.
    • Elevated numbers of T and B lymphocytes, including Fc IgG receptor-bearing T cells, were found in the splenectomized group.

    Conclusions:

    • Splenectomy following highly selective vagotomy is associated with significant hematological changes, including lymphocytosis, monocytosis, and thrombocytosis.
    • The observed alterations in lymphocyte subsets warrant further functional investigation to elucidate their clinical significance, particularly concerning plasma IgM levels.
    • Splenectomy did not appear to compromise complement activation pathways.