Simultaneous gallbladder-preserving cholecystolithotomy and laparoscopic splenectomy as a surgical option for hereditary spherocytosis in a child: A case report

Introduction. Though, in developed countries, laparoscopy is now a gold standard for splenectomy, we are lacking in this aspect in the eastern world. Splenectomy has mostly been performed by open surgery in our region. This is our effort to introduce laparoscopic splenectomy in our country.Methods. This is a retrospective cohort study done in patients presenting to hematology and surgery department of our hospital who underwent laparoscopic splenectomy for hematological diseases from January 2013 to December 2016.Results. There were 50 patients (38 females, 12 males). The diagnoses were idiopathic thrombocytopenic purpura in 31, (steroid/azathioprine-resistant, steroid dependent), hereditary spherocytosis in 9, alpha-thalassemia in 3, beta-thalassemia in 2, autoimmune hemolytic anemia in 4, and isolated splenic tuberculosis in 1. Average platelet counts preoperatively were62000±11000/mm3 (range 52000-325000/mm3). The mean operative time was130±49minutes (range 108-224 min). The mean postoperative stay was4±2.11days (range 3-9 days). Laparoscopic splenectomy could be completed in 45 (90%) patients.Conclusion. Laparoscopic splenectomy could be successfully contemplated in patients with hematological diseases, especially if spleen is normal or only mildly enlarged, and is an advantageous alternative to open splenectomy. Absence of ideal resources has not limited our progress in minimal access approach.

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Laparoscopic splenectomy: how minimal can we make it?

Journal of Pediatric Endoscopic Surgery ◽

10.1007/s42804-021-00125-6 ◽

2022 ◽

Author(s):

Adetokunbo Fadipe ◽

David Wilkinson ◽

Robert Peters ◽

Catherine Doherty ◽

Nick Lansdale

Keyword(s):

Length Of Stay ◽

Laparoscopic Splenectomy ◽

Operative Time ◽

Hereditary Spherocytosis ◽

Surgical Trauma ◽

Cell Disease ◽

Median Length ◽

Post Operative Pain ◽

Age At Surgery ◽

Splenic Size

Abstract Aims Laparoscopic splenectomy (LS) is routinely performed in children, however, a large spleen in a small child can pose significant operative challenges. We instigated a highly standardised surgical and anaesthetic approach to LS to minimise surgical trauma and enhance recovery. The aim of this study was to assess the outcomes of this programme. Methods Prospective study of all LS’s performed 2018–2021. Surgical approach was via one 10 mm and three 5 mm ports. Early hilar control was accomplished with Hem-o-loks. Splenic retrieval via the 10 mm incision used finger morcellation within an Espiner EcoSac. Anaesthesia utilised a standardised regime of agents and bupivacaine was infiltrated to the splenic bed and wound sites. Post-operative opiates were minimised. Data are presented as median [IQR]. Results Twenty consecutive children were included. Indications for LS were hereditary spherocytosis (n = 12), sickle cell disease (n = 6), beta-thalassaemia (n = 1) and splenic haemangiomatosis (n = 1). Age at surgery was 101 months [75–117] and weight 30 kg [21–37]. Splenic size was 13.4 cm [12–14.4]. Operative time was 178 min [156–185]. There were no open conversions and no significant intra or post-operative bleeding. One patient developed pancreatitis. Median post-operative pain score was 1 [1–3]. Median length of stay was 2 days [2–3]. Conclusion LS is feasible, safe and efficient in smaller children with large spleens. This standardised programme of anaesthesia and surgery based around a core team reliably results in few complications, good analgesia and short length of stay.

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A Case Report Wandering Spleen in a Young Primiparous Woman Treated by Laparoscopic Splenectomy: A Case Report

International Journal of Clinical Research ◽

10.38179/ijcr.v1i1.17 ◽

2020 ◽

Vol 1 (1) ◽

pp. 29-33

Author(s):

Jad Terro ◽

Bilal El-Chamaa ◽

Sary Abdallah ◽

Kassem Jammoul ◽

Rayan El Lakkis ◽

...

Keyword(s):

Case Report ◽

Laparoscopic Splenectomy ◽

Imaging Techniques ◽

Color Doppler ◽

Pregnant Patient ◽

Reproductive Age ◽

Wandering Spleen ◽

Primiparous Woman ◽

Term Baby ◽

Enhanced Computed Tomography

Background: Wandering spleen (WS) is an uncommon splenic disorder defined as the displacement of the spleen from its usual anatomical position. It is most prevalent in females in their reproductive age. It can be encountered incidentally or may present with symptoms. Risks of complications exist and vary with the presentation. Several imaging techniques are able to define it clearly preoperatively. Laparoscopic surgery is the definitive diagnostic and therapeutic method. Case Report: A 24-year-old pregnant female patient presented to the Emergency Department complaining of intermittent dull abdominal pain and pelvic heaviness for 9 days. Contrast- Enhanced Computed Tomography and a color Doppler sonography of the abdomen and pelvis showed a large-sized spleen in the pelvis corresponding to a diagnosis of WS, without ischemic signs. The patient underwent a laparoscopic splenectomy and was vaccinated for Haemophilus influenza, meningococcus, and pneumococcus postoperatively. The post-operative period was uneventful, and the patient later delivered a full-term baby girl by a Cesarean section. Conclusion: This is, to the best of our knowledge, the second reported case of laparoscopic splenectomy in a pregnant patient with WS. While splenopexy is associated with better outcomes, splenectomy seems to be preferred in pregnant patients, who may undergo a vaginal delivery, but guidelines and data are still scarce regarding the management of WS in pregnancy. Vaccination against encapsulated bacteria is required in case of splenectomy

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A Laparoscopic Splenectomy in Combination with Cholecystectomy in the Treatment of Hereditary Spherocytosis and Cholecystolithiasis.

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.29.1050 ◽

1996 ◽

Vol 29 (5) ◽

pp. 1050-1054

Author(s):

Toru Beppu ◽

Yoshihiro Masuda ◽

Shigeru Katafuchi ◽

Hiroshi Egami ◽

Kazuko Sakai ◽

...

Keyword(s):

Laparoscopic Splenectomy ◽

Hereditary Spherocytosis

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Extramedullary hematopoiesis of the sphenoid sinus associated with hereditary spherocytosis: A case report

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2018.08.012 ◽

2018 ◽

Vol 114 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Jaron Densky ◽

Tirth Patel ◽

Ashleigh Halderman ◽

Prashant Malhotra

Keyword(s):

Case Report ◽

Sphenoid Sinus ◽

Hereditary Spherocytosis ◽

Extramedullary Hematopoiesis

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Primary splenic hydatidosis: a case report

Journal of International Medical Research ◽

10.1177/0300060519845500 ◽

2019 ◽

Vol 48 (2) ◽

pp. 030006051984550

Author(s):

Qiang Wang ◽

Ming-quan Pang ◽

Ying-li Kang ◽

Zhi-xin Wang ◽

Dongzhi Cairang ◽

...

Keyword(s):

Case Report ◽

Laparoscopic Splenectomy ◽

Serological Test ◽

Chronic Atrophic Gastritis ◽

Pathological Examination ◽

Test Results ◽

Imaging Findings ◽

Pastoral Area ◽

History Of

We herein report a case of primary splenic hydatidosis to provide data regarding the diagnosis, treatment, and epidemiological statistics of this disease. The patient was from a pastoral area and was diagnosed with primary splenic hydatidosis with chronic atrophic gastritis. The patient had no history of surgical treatment of hydatidosis. The diagnosis was mainly based on possible exposure to endemic areas, imaging findings, serological test results, and operative and pathological examination findings. Laparoscopic splenectomy was performed, and regular albendazole therapy was given after the operation. The patient was admitted to the hospital for gastrointestinal bleeding 3 months postoperatively, and she was successfully treated and discharged. No recurrence of hydatid foci has been observed since the follow-up.

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