Splenectomy for hypersplenism with or without preoperative splenic artery embolisation

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Abstract

Background: Although splenectomy is considered the preferred treatment for hypersplenism, intraoperative blood loss remains a common occurrence. We prospectively compared the perioperative and clinical outcome of splenic artery embolisation (SAE) before open splenectomy (OS) versus OS alone in two concurrent patient groups. Methods: From January 2016 to January 2018, 50 patients with hypersplenism underwent combined SAE and OS (study group). For comparison, we considered 50 age- and gender-matched case controls undergoing OS without prior SAE during the same period (control group). Perioperative and clinical outcomes were compared between the two groups. Mann–Whitney U test, Student’s t-test, χ2 or Fisher’s exact test were used as appropriate. Results: No significant differences were found between the two groups for age, gender and laboratory investigations (p ≥ 0.250). Mortality rate was zero in both groups. No patients of the study group needed perioperative blood transfusion in comparison with patients of the control group (p = 0.003). A significant increase in platelet count was noted in the study group after SAE compared to the control group (p = 0.024). No significant differences between the two groups were observed for operating time, postoperative complications and postoperative stay (p ≥ 0.237). Conclusion: We confirm that preoperative SAE in patients who undergo splenectomy for hypersplenism significantly reduces the need for blood transfusion in comparison to splenectomy without prior embolisation. Preoperative SAE is a safe procedure with neither morbidity nor mortality.

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Zaitoun, M. M. A., Basha, M. A. A., Raafat, A., Rushdy, T., & Mawla, W. A. (2018). Splenectomy for hypersplenism with or without preoperative splenic artery embolisation. European Radiology Experimental, 2(1). https://doi.org/10.1186/s41747-018-0053-6

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