Complications of Splenectomy: Etiology, Prevention, and Management

Ellison, E. Christopher; Fabri, Peter J.

doi:10.1016/s0039-6109(16)43191-9

Cited by 184 publications

(76 citation statements)

References 58 publications

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“…Portal vein system thrombosis was once considered a rare complication after splenectomy (6). With the introduction of advanced image devices, there have been cumulating evidences showing that the incidence of PVST secondary to splenectomy was significantly higher than previously reported (7).…”

Section: Introductionmentioning

confidence: 99%

The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization

Zheng²,

Zhang³

et al. 2015

Turk J Gastroenterol

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Background/Aims: This study aimed to investigate the incidence and risk factors of portal vein system thrombosis (PVST) in patients with liver cirrhosis after splenectomy and pericardial devascularization. Materials and Methods: We retrospectively analyzed 71 patients who underwent splenectomy with pericardial devascularization for portal hypertension due to cirrhosis. Patients were categorized into Group A (n=23): early prophylactic anticoagulants therapy; Group B (n=29): late prophylactic anticoagulants therapy; and Group C (n=19): no anticoagulation therapy. Univariate and multivariate analyses of the risk factors of PVST were performed. The incidence of PVST and the effect of thrombolytic therapy were evaluated. Results: Multivariate analysis revealed a wider preoperative splenic vein diameter (≥8 mm), and lower preoperative platelet counts (<50×10

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Section: Introductionmentioning

confidence: 99%

The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization

Zheng²,

Zhang³

et al. 2015

Turk J Gastroenterol

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“…Historically, there is more than fifty years, Manley and Marius observed that the small spleen autotransplants had capacity to regenerate 4 . The implant viability is influenced by several factors, such as it size, it forms and place.…”

Section: Introductionmentioning

confidence: 99%

Late histological aspects of spleen autologous transplantation in rats

et al. 2008

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Purpose:To evaluate macro and microscopically the late evolution of autotransplants of fragments of spleen in the greater omentum, mesenterium and peritoneal cavity, after 24 weeks of observation. Methods: Fifty two Wistar rats were used, males and adults, submitted to total splenectomy and divided in four groups. The group I -seventeen animals with implant of spleen fragment in the peritoneal cavity; group II -eighteen animals with implant in the omentum and group III -seventeen animals with implant fixed in mesenterium root. The group control (group IV) was formed by eight animals chosen aleatorily among the three groups. It was analyzed macro and microscopically the evolution of the implant, and in the histological study qualitative and quantitative criteria were adopted, with the counting of no cellular e cellular elements. Results: It was observed adherences to the adjacent tissues and vascularization in all of the fragments transplanted. The group I presented white pulp and preserved vascularization. In the group II were observed white pulp with follicular formations and lymphoid tissue preserved, and the red pulp in cordon aspect and hemorrhagic. In the group III were observed with depletion of white and red pulp, while others evidenced better preservation of the pulps. The counting of lymphocytes revealed significant difference between the groups I and IV and the group III and IV (p < 0.05). The counting of active macrophages revealed significant difference between the groups II and III (p < 0.05) and similarity between II and IV (p > 0.05). The other elements: active macrophages phagocyting hemosiderine, plasmocytes, fibroblasts, fibrocytes, giant cells, monocytes, interstitial spaces and fibers of collagen, did not show significant difference among the groups. Conclusions: The splenic autotransplantation is feasible, being the better place the greater omentum. This research demonstrated through qualitative and quantitative histological analysis that the splenic tissue autotransplanted in the omentum of Wistar rats preserves its function of defense of the organisms. Key words: Spleen. Transplantation, Autologous. Macrophages. Rats. RESUMO Objetivo:Avaliar macro e microscopicamente a evolução tardia do autotransplante de fragmentos de baço no grande epiplon, mesentério e cavidade peritoneal, após 24 semanas de observação. Métodos: Foram utilizados 52 ratos Wistar, machos e adultos, submetidos a esplenectomia total e divididos em quatro grupos. O grupo I -dezessete animais com implante de fragmento de baço solto na cavidade peritoneal; grupo II -dezoito animais com implante no grande epiplon e grupo III -dezessete animais com implante fixado na raiz do mesentério. O grupo controle (grupo IV) foi formado por oito animais escolhidos aleatoriamente entre os três grupos. Foram analisados macro e microscopicamente a evolução do implante, sendo que no estudo histológico foram adotados critérios qualitativos e quantitativos, com a contagem de elementos celulares e não celulares. Resultados: Foram observ...

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“…Splenectomy however is associated with sepsis related deaths in 1.9% in adults and 4% in children [14]. None of the 11 patients in our series who underwent total splenectomy developed postoperative sepsis.…”

Section: Discussionmentioning

confidence: 89%

Splenectomy versus Spleen-Preserving Surgery for Splenic Echinococcosis

Atmatzidis¹,

Papaziogas²,

Mirelis³

et al. 2003

Dig Surg

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Background/Aims: The spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyse the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing splenectomy with spleen-preserving surgery. Methods: During a period of 25 years (1976–2001), 19 (5.4%) patients with splenic echinococcosis were treated in our department out of 349 patients with abdominal hydatid disease. In 16 patients the spleen was the only organ involved, while in 3 patients the liver was also affected. Results: Eleven patients had splenectomy and in the other 8 the spleen was preserved: enucleation (n = 4), partial cystectomy and omentoplasty (n = 2) and cystojejunal Roux-en-Y anastomosis (n = 2). One (6%) patient died in the early postoperative period and 5 (29%) patients had postoperative complications. There was no significant difference between the splenectomy and spleen-preserving groups concerning median hospital stay and postoperative complication rate. The median follow-up in 15 patients was 52 (range 6–300) months. Two patients (13%) developed recurrence of the disease requiring re-operation at 2 and 3 years, respectively. Recurrence occurred in 1 (12%) patient in the splenectomy group and in 1 (14%) out of 7 patients in the spleen-preserving group. Conclusion: In the present series it was possible to preserve the spleen in 8 (42%) of 19 patients, without significant increase of recurrent echinococcosis.

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Complications of Splenectomy: Etiology, Prevention, and Management

Cited by 184 publications

References 58 publications

The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization

The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization

Late histological aspects of spleen autologous transplantation in rats

Splenectomy versus Spleen-Preserving Surgery for Splenic Echinococcosis

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