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World Journal of Surgery

, Volume 32, Issue 12, pp 2730–2735 | Cite as

Twenty Years of Splenic Preservation in Trauma: Lower Early Infection Rate Than in Splenectomy

  • Jean-Marc Gauer
  • Susanne Gerber-Paulet
  • Christian Seiler
  • Walter Paul SchweizerEmail author
Article

Abstract

Background

Retrospective studies concerning the operative preservation and nonoperative management of splenic injuries in patients with splenic trauma have been published; however, few studies have analyzed prospectively the results and early complication rates of a defined management in splenic injury.

Methods

From 1986 to 2006, adult patients with blunt splenic injuries were evaluated prospectively with the intent of splenic preservation. Hemodynamically unstable patients underwent laparotomy. Stable patients were treated conservatively regardless of the grade of splenic injury determined by ultrasound and/or CT scan.

Results

During a 20-year period, 155 patients were prospectively evaluated. In 98 patients (63%), the spleen could be preserved by nonoperative (64 patients, 65%) or operative (34 patients, 35%) treatment and 57 patients (37%) needed splenectomy. There were no differences in age, sex, or trauma score between the groups, but a higher early infection rate in patients with splenectomy compared with patients with splenic preservation (p < 0.005) was observed, even if the patients were matched with respect to multiple trauma using the Injury Severity Score (p < 0.01).

Conclusions

Splenic preservation in patients with blunt splenic injury by operative or nonoperative treatment leads to lower early infection rates in adults and, therefore, should be advocated.

Keywords

Injury Severity Score Nonoperative Treatment Splenic Injury Secondary Bleeding Partial Splenectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Jean-Marc Gauer
    • 1
  • Susanne Gerber-Paulet
    • 1
  • Christian Seiler
    • 2
  • Walter Paul Schweizer
    • 1
    Email author
  1. 1.Department of SurgeryKantonsspitalSchaffhausenSwitzerland
  2. 2.Department of Visceral and Transplantation Surgery, InselspitalUniversity of BerneBerneSwitzerland

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