Laparoscopic Partial Cystectomy for Non-Parasitic Splenic Cyst: A Case and Literature Review

Abstract

Nonparasitic splenic cysts are rare and no treatment guidelines exists. Laparoscopic partial cystectomy is an attractive minimally invasive spleen preserving treatment option. The aim of this paper is to share our experience and review evidence to support laparoscopic partial cystectomy. A search was performed of PubMed and Ovid Embase. All human studies published in English language describing laparoscopic management of non-parasitic splenic cysts without any age restrictions were reviewed. Forty two studies fulfilled inclusion and exclusion criteria out of 254 studies. The total number of patients were 134. All studies were case reports or retrospective case series which ranged in size from one to 14 patients. Ten studies (24%) involved paediatric patients. Majority of patients were female. Median age ranged from 8.5-43 and median operative time varied between 56-120 min. One study reported bleeding from the cyst wall requiring splenectomy. All other studies did not report any major intra operative or post-operative complications. Median follow up period varied from 6-60 months. Overall recurrence rates varied from 0-100%. When all 134 partial cyst excisions are considered overall, 25 patients developed recurrent cysts leading to a recurrence rate of 19%. Only 13 patients (9.7%) developed symptomatic recurrences needing further intervention. Laparoscopic partial cyst excision is a relatively straightforward safe and effective spleen preserving surgical option with acceptable recurrence rate in the treatment of nonparasitic symptomatic splenic cysts.