Late follow-up of patients submitted to subtotal splenectomy: late clinical, laboratory, imaging and functional with preservation of the upper splenic pole

Abstract

objective: To evaluate the follow-up of patients submitted to splenectomy with preservation of the upper splenic pole. Methods: All patients undergoing subtotal splenectomy were invited to be reviewed. A total of 86 patients submitted to this surgery were studied. The procedure was performed due to one of the following conditions: portal hypertension due to schistosomiasis (n = 43), trauma (n = 31), Gaucher’s disease (n = 4), myeloid hepatosplenomegaly due to myelofibrosis (n = 3), splenomegalic retarded growth and sexual development (n = 2), severe pain due to splenic ischemia (n = 2) and pancreatic cystadenoma (n = 1). All patients underwent hematologic tests, immunological assessment, abdominal ultrasonography, computed tomography (CT), scintigraphy and endoscopy. Rresults: Increased white blood cell and platelet counts were the only hematological abnormalities. No immune deficit was found. Esophageal varices were still present in patients who underwent surgery because of portal hypertension, but none had a re-bleeding event. The ultrasonography, tomography and scintigraphy confirmed the presence of functional splenic remnants without significant size alteration. Conclusions: Subtotal splenectomy seems to be a safe procedure that can be useful to treat conditions involving the spleen. The functions of the splenic remnants are preserved during long periods of time.

Keywords

• Splenectomy/methods
• Spleen
• Postoperative period