Skip to main content
SpringerLink
Log in

Laparoscopic partial splenectomy with temporary occlusion of the trunk of the splenic artery in fifty-one cases: experience at a single center

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Laparoscopic partial splenectomy (LPS) for splenic benign space-occupying lesions has been reported by many researchers; however, few studies have described methods to control intraoperative bleeding. Trustworthy experience in LPS with a satisfactory intraoperative hemorrhage control technique is therefore necessary. The current study aims to present our experience in LPS with temporary occlusion of the trunk of the splenic artery for controlling intraoperative bleeding with a large sample of 51 cases and to evaluate the safety, feasibility, and reproducibility of this technique.

Methods

Fifty-one patients from August 2014 to April 2019 who underwent LPS in our institution were retrospectively analyzed. Surgical techniques were described in detail.

Results

All patients had successfully undergone LPS with temporary occlusion of the trunk of the splenic artery. Conversions to open surgery, hand-assisted laparoscopic splenectomies, or blood transfusions were not needed. The operative time was 94.75 ± 18.91 min, the estimated blood loss was 71.13 ± 53.87 ml, and the volume of resected spleen was 34.75 ± 12.19%. The range of postoperative stays was 4–14 days. One female patient (2%, 1/51) suffered from postoperative complications. No perioperative mortality, incision infections, postoperative pancreatic fistulas (POPFs), splenic infarctions, or portal/splenic vein thromboembolic events occurred.

Conclusion

LPS is an effective spleen-preserving surgery. Although there are many other bleeding control methods, temporarily occluding the trunk of the splenic artery was found to be a safe, feasible, and reproducible technique in LPS. The outcomes of this technique and the efficacy of splenic parenchyma preservation are acceptable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kristinsson SY, Gridley G, Hoover RN, Check D, Landgren O (2014) Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up. Haematologica 99(2):392–398

    Article  Google Scholar 

  2. Di Sabatino A, Carsetti R, Corazza GR (2011) Post-splenectomy and hyposplenic states. Lancet 378(9785):86–97

    Article  Google Scholar 

  3. Schilling RF (1997) Spherocytosis, splenectomy, strokes, and heat attacks. Lancet 350(9092):1677–1678

    Article  CAS  Google Scholar 

  4. Lucas CE (1991) Splenic trauma. Choice of management. Ann Surg 213(2):98–112

    Article  CAS  Google Scholar 

  5. Hansen K, Singer DB (2001) Asplenic-hyposplenic overwhelming sepsis: postsplenectomy sepsis revisited. Pediatr Dev Pathol 4(2):105–121

    Article  CAS  Google Scholar 

  6. Tracy ET, Haas KM, Gentry T, Danko M, Roberts JL, Kurtzberg J, Rice HE (2011) Partial splenectomy but not total splenectomy preserves immunoglobulin M memory B cells in mice. J Pediatr Surg 46(9):1706–1710

    Article  Google Scholar 

  7. Wolf HM, Eibl MM, Georgi E, Samstag A, Spatz M, Uranus S, Passl R (1999) Long-term decrease of CD4+CD45RA+ T cells and impaired primary immune response after post-traumatic splenectomy. Br J Haematol 107(1):55–68

    Article  CAS  Google Scholar 

  8. Goldthorn JF, Schwartz AD, Swift AJ, Winkelstein JA (1978) Protective effect of residual splenic tissue after subtotal splenectomy. J Pediatr Surg 13(6D):587–590

    Article  CAS  Google Scholar 

  9. Bader-Meunier B, Gauthier F, Archambaud F, Cynober T, Mielot F, Dommergues JP, Warszawski J, Mohandas N, Tchernia G (2001) Long-term evaluation of the beneficial effect of subtotal splenectomy for management of hereditary spherocytosis. Blood 97(2):399–403

    Article  CAS  Google Scholar 

  10. Uranus S, Pfeifer J, Schauer C, Kronberger L, Rabl H, Ranftl G, Hauser H, Bahadori K (1995) Laparoscopic partial splenic resection. Surg Laparosc Endosc 5(2):133–136

    CAS  PubMed  Google Scholar 

  11. Poulin EC, Thibault C, DesCoteaux JG, Cote G (1995) Partial laparoscopic splenectomy for trauma: technique and case report. Surg Laparosc Endosc 5(4):306–310

    CAS  PubMed  Google Scholar 

  12. Wang X, Wang M, Zhang H, Peng B (2014) Laparoscopic partial splenectomy is safe and effective in patients with focal benign splenic lesion. Surg Endosc 28(12):3273–3278

    Article  Google Scholar 

  13. Li H, Wei Y, Peng B, Li B, Liu F (2017) Feasibility and safety of emergency laparoscopic partial splenectomy: a retrospective analysis. Medicine (Baltimore) 96(16):e6450

    Article  Google Scholar 

  14. Schier F, Waag KL, Ure B (2007) Laparoscopic unroofing of splenic cysts results in a high rate of recurrences. J Pediatr Surg 42(11):1860–1863

    Article  Google Scholar 

  15. Uranues S, Grossman D, Ludwig L, Bergamaschi R (2007) Laparoscopic partial splenectomy. Surg Endosc 21(1):57–60

    Article  CAS  Google Scholar 

  16. Liu G, Fan Y (2019) Feasibility and safety of laparoscopic partial splenectomy: a systematic review. World J Surg 43(6):1505–1518

    Article  Google Scholar 

  17. de la Villeon B, Zarzavadjian Le Bian A, Vuarnesson H, Munoz Bongrand N, Halimi B, Sarfati E, Cattan P, Chirica M (2015) Laparoscopic partial splenectomy: a technical tip. Surg Endosc 29(1):94–99

    Article  Google Scholar 

  18. Han XL, Zhao YP, Chen G, Wu WM, Dai MH (2015) Laparoscopic partial splenectomy for splenic hemangioma: experience of a single center in six cases. Chin Med J (Engl) 128(5):694–697

    Article  Google Scholar 

  19. Balaphas A, Buchs NC, Meyer J, Hagen ME, Morel P (2015) Partial splenectomy in the era of minimally invasive surgery: the current laparoscopic and robotic experiences. Surg Endosc 29(12):3618–3627

    Article  Google Scholar 

  20. Hery G, Becmeur F, Mefat L, Kalfa D, Lutz P, Lutz L, Guys JM, de Lagausie P (2008) Laparoscopic partial splenectomy: indications and results of a multicenter retrospective study. Surg Endosc 22(1):45–49

    Article  Google Scholar 

  21. Borie F (2016) Laparoscopic partial splenectomy: surgical technique. J Visc Surg 153(5):371–376

    Article  CAS  Google Scholar 

  22. Patrzyk M, Glitsch A, Hoene A, von Bernstorff W, Heidecke CD (2011) Laparoscopic partial splenectomy using a detachable clamp with and without partial splenic embolisation. Langenbecks Arch Surg 396(3):397–402

    Article  Google Scholar 

  23. Zheng L, Deng C, Li J, Wang L, You N, Wu K, Wang W (2018) Treatment of hemangioma of the spleen by preoperative partial splenic embolization plus laparoscopic partial splenectomy: a case report. Medicine (Baltimore) 97(17):e0498

    Article  Google Scholar 

  24. Khelif K, Maassarani F, Dassonville M, Laet MH (2006) Laparoscopic partial splenectomy using radiofrequency ablation for nonparasitic splenic cysts in two children. J Laparoendosc Adv Surg Tech A 16(4):414–417

    Article  Google Scholar 

  25. Gumbs AA, Bouhanna P, Bar-Zakai B, Briennon X, Gayet B (2008) Laparoscopic partial splenectomy using radiofrequency ablation. J Laparoendosc Adv Surg Tech A 18(4):611–613

    Article  Google Scholar 

  26. Okano K, Kakinoki K, Suto H, Oshima M, Akamoto S, Hagiike M, Usuki H, Suzuki Y (2011) Hand-assisted laparoscopic partial splenectomy using an endopath monopolar sealer. Surg Laparosc Endosc Percutan Tech 21(6):e291–294

    Article  Google Scholar 

  27. Liu DL, Xia S, Xu W, Ye Q, Gao Y, Qian J (1996) Anatomy of vasculature of 850 spleen specimens and its application in partial splenectomy. Surgery 119(1):27–33

    Article  CAS  Google Scholar 

  28. Cai Y, Gao P, Li Y, Wang X, Peng B (2018) Laparoscopic pancreaticoduodenectomy with major venous resection and reconstruction: anterior superior mesenteric artery first approach. Surg Endosc 32(10):4209–4215

    Article  Google Scholar 

  29. Teperman SH, Whitehouse BS, Sammartano RJ, Rojas-Corona R, Poulis D, Boley SJ (1994) Bloodless splenic surgery: the safe warm-ischemic time. J Pediatr Surg 29(1):88–92

    Article  CAS  Google Scholar 

  30. Habermalz B, Sauerland S, Decker G, Delaitre B, Gigot JF, Leandros E, Lechner K, Rhodes M, Silecchia G, Szold A et al (2008) Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc 22(4):821–848

    Article  CAS  Google Scholar 

Download references

Funding

This study has not been funded.

Author information

Authors and Affiliations

  1. Sichuan University, Chengdu, China

    Guoqing Ouyang & Bing Peng

  2. Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan Province, China

    Guoqing Ouyang, Xin Wang & Bing Peng

  3. Department of Minimal Invasive Surgery, Shangjin Nanfu Hospital, Chengdu, China

    Yongbin Li, Yunqiang Cai, He Cai & Bing Peng

Authors
  1. Guoqing Ouyang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yongbin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yunqiang Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. He Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bing Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

GO designed and wrote the study; YL and GO collected the data. YC, XW and HC analyzed the data. BP made the final approval of the version to be published.

Corresponding author

Correspondence to Bing Peng.

Ethics declarations

Disclosures

Drs. Guoqing Ouyang, Yongbin Li, Yunqiang Cai, Xin Wang, He Cai, and Bing Peng have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The paper is not based on a previous communication to a society or meeting.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ouyang, G., Li, Y., Cai, Y. et al. Laparoscopic partial splenectomy with temporary occlusion of the trunk of the splenic artery in fifty-one cases: experience at a single center. Surg Endosc 35, 367–373 (2021). https://doi.org/10.1007/s00464-020-07410-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-07410-0

Keywords

Search

Navigation