What are the surgical approaches used in the treatment of splenic infarct?

Updated: Jul 27, 2020
  • Author: Manish Parikh, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

The approach (eg, laparoscopy, midline laparotomy, or left subcostal incision) is determined by the underlying pathology/clinical scenario, as well as by the surgeon's preference. The presence of splenic infarct (or abscess) is not per se a contraindication for laparoscopy. Generally, the laparoscopic approach is contraindicated in emergency situations, such as hemorrhagic shock and spontaneous rupture. The surgeon's experience determines the point at which the enlarged spleen is too large to remove laparoscopically.

Because of the risk of lifelong susceptibility to infectious complications after splenectomy (particularly the rare but highly fatal OPSS), laparoscopic or open partial splenectomy should be attempted when feasible. Laparoscopic spleen-preserving distal pancreatectomy, with or without splenic-vessel preservation, has yielded promising results. [25]


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