Our Summary

This research paper studies two types of surgery: one where the spleen is preserved (LSPDP) and one where it is removed (LDPS), both performed using a laparoscopic method (tiny incisions instead of a big cut) in the distal pancreas (the tail end of the pancreas). The study looked at patients from 2006 to 2016 in the UK, matching 173 cases of each type of surgery. The results showed that there was no difference in the rate of complications after surgery between the two groups. The only identified risk factor for having the spleen removed unexpectedly was if the tumor size was 30mm or larger. The conclusion is that keeping the spleen during this type of surgery doesn’t lower the chance of complications after surgery compared to removing it. The size of the tumor is an important factor to consider when planning for this type of surgery.

FAQs

  1. What are the two types of surgery mentioned in the study and how are they performed?
  2. Was there a difference in the rate of complications between the two types of surgeries?
  3. What was identified as a risk factor for having the spleen removed unexpectedly during surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to follow post-operative instructions carefully, including taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments. It is also important to be aware of the potential risks and complications associated with splenectomy, such as infection or bleeding, and to seek medical attention if any concerning symptoms arise. Additionally, patients should discuss with their healthcare provider about the importance of vaccinations and preventive measures to protect against infections, as the spleen plays a key role in the immune system.

Suitable For

Patients who are typically recommended splenectomy include those with:

  1. Pancreatic tumors located in the distal pancreas, particularly if the tumor size is 30mm or larger.
  2. Patients who have been diagnosed with conditions such as pancreatic cancer or pancreatic neuroendocrine tumors.
  3. Patients who have experienced trauma to the spleen that cannot be repaired through other means.
  4. Patients with certain blood disorders, such as hereditary spherocytosis or autoimmune hemolytic anemia, that affect the function of the spleen.
  5. Patients with certain types of infections, such as splenic abscesses or recurrent episodes of splenic sequestration in sickle cell disease, that require removal of the spleen to prevent further complications.

It is important for patients to discuss the risks and benefits of splenectomy with their healthcare provider to determine if this surgical procedure is the best course of action for their specific medical condition.

Timeline

Before splenectomy:

  • Patient is diagnosed with a condition or disease that requires the removal of the spleen
  • Patient undergoes pre-operative tests and evaluations to assess their overall health and suitability for surgery
  • Patient discusses the risks and benefits of splenectomy with their healthcare provider
  • Surgery date is scheduled and patient prepares for the procedure by following pre-operative instructions

After splenectomy:

  • Patient undergoes laparoscopic splenectomy surgery
  • Post-operative care includes pain management, monitoring for complications, and gradual return to normal activities
  • Patient may need to take antibiotics and receive vaccinations to prevent infections, as the spleen plays a role in the immune system
  • Patient is advised to avoid activities that may increase the risk of injury or infection, such as contact sports or travel to certain regions
  • Long-term follow-up care may be necessary to monitor for any potential complications or changes in health status

What to Ask Your Doctor

  1. What are the potential risks and complications associated with splenectomy?
  2. How will my immune system be affected by having my spleen removed?
  3. Will I need any vaccinations or medications to help prevent infections after spleen removal?
  4. How will my overall health and quality of life be impacted by splenectomy?
  5. Are there any long-term effects or complications I should be aware of?
  6. How will my body compensate for the loss of the spleen’s functions?
  7. What are the alternatives to splenectomy for my condition?
  8. How experienced are you in performing this type of surgery, and what is your success rate?
  9. What is the recovery process like after splenectomy?
  10. Are there any lifestyle changes or precautions I should take after the surgery?

Reference

Authors: Moekotte AL, Lof S, White SA, Marudanayagam R, Al-Sarireh B, Rahman S, Soonawalla Z, Deakin M, Aroori S, Ammori B, Gomez D, Marangoni G, Abu Hilal M; Minimally Invasive liver and Pancreatic Surgery Study Group-UK (MI-LAPS UK). Journal: Surg Endosc. 2020 Mar;34(3):1301-1309. doi: 10.1007/s00464-019-06901-z. Epub 2019 Jun 24. PMID: 31236723