Our Summary

This research paper looks into the process of performing two surgeries at the same time - removing the spleen and the gallbladder. This is often done for patients who have diseases related to both organs. The researchers looked at studies that have been published on this topic, focusing on why the surgery was done, how it was done, and the outcome for the patient.

They found eight studies that included a total of 108 patients who had undergone these surgeries. The patients ranged widely in age, with an average age of around 27 years. The most common reasons for the surgery were hereditary spherocytosis (a disorder that causes anemia) and sickle cell disease or beta-thalassemia (both blood disorders).

In most cases, the gallbladder was removed first. The surgery usually involved five small cuts (or “trocars”). On average, the surgery took about 170 minutes. The spleens removed weighed on average 600g and were about 19cm long. Only about 3% of the surgeries had to be converted to a traditional open surgery, and about 20% of patients experienced complications after the surgery, most commonly lung infection or blood clots in the portal or splenic vein. No patients died after the surgery, and they typically stayed in the hospital for about 5 days afterwards.

The researchers concluded that performing these two surgeries at the same time is safe and practical for patients with diseases affecting both the spleen and the gallbladder. However, they also suggest that more high-quality clinical trials are needed to further understand the best methods and outcomes for this type of surgery.

FAQs

  1. What are the most common indications for concomitant laparoscopic splenectomy and cholecystectomy (CLSC)?
  2. What is the average duration of the CLSC procedure and how long is the typical hospitalization period after surgery?
  3. What are the most common postoperative complications of CLSC?

Doctor’s Tip

A helpful tip a doctor might tell a patient about splenectomy is to follow postoperative instructions closely, including taking prescribed medications, avoiding heavy lifting or strenuous activity, and attending follow-up appointments to monitor recovery and address any concerns. It is also important to be aware of signs of infection, such as fever, redness, or swelling at the surgical site, and to seek medical attention if these symptoms occur.

Suitable For

Patients who are typically recommended for splenectomy include those with hereditary spherocytosis, sickle cell disease, β-thalassemia, and other conditions that affect the spleen. These patients may require splenectomy in cases where conservative treatment has been unsuccessful or when there are complications such as splenic infarction, hypersplenism, or splenic abscess. Additionally, patients with certain types of cancers, such as lymphoma or leukemia, may also be recommended for splenectomy as part of their treatment plan.

Timeline

Before splenectomy:

  1. Patient undergoes diagnostic tests and evaluations to determine the need for splenectomy.
  2. Patient may have symptoms such as abdominal pain, fatigue, and frequent infections.
  3. Surgery indications are determined, such as hereditary spherocytosis or sickle cell disease.
  4. Laparoscopic cholecystectomy may be performed first in some cases.
  5. Patient is prepared for surgery with preoperative evaluations and instructions.

After splenectomy:

  1. Laparoscopic splenectomy is performed, with a mean operation duration of 170.18 minutes.
  2. Resected spleen weight is measured and postoperative complications may occur, such as pulmonary infection or portal/splenic vein thrombosis.
  3. Patient is monitored in the hospital for an average of 5.43 days.
  4. Patient may experience a recovery period at home, with follow-up appointments to monitor healing and address any complications.
  5. Patient may need to undergo additional treatments or therapies to manage any associated conditions or complications.

What to Ask Your Doctor

  1. What are the specific indications for me to undergo a splenectomy in conjunction with a cholecystectomy?
  2. What is the expected outcome of a concomitant laparoscopic splenectomy and cholecystectomy in terms of recovery time and potential complications?
  3. How will the surgery be performed, and what is the expected duration of the procedure?
  4. What are the potential risks and complications associated with a simultaneous splenectomy and cholecystectomy?
  5. How long will I need to stay in the hospital after the surgery, and what is the expected recovery time?
  6. Will I need any special follow-up care or monitoring after the surgery?
  7. Are there any specific lifestyle changes or precautions I should take after the procedure?
  8. What are the long-term effects of having a splenectomy, and how will it affect my overall health and immune function?

Reference

Authors: Schizas D, Katsaros I, Karatza E, Kykalos S, Spartalis E, Tsourouflis G, Dimitroulis D, Nikiteas N. Journal: J Laparoendosc Adv Surg Tech A. 2020 Jul;30(7):730-736. doi: 10.1089/lap.2020.0004. Epub 2020 Mar 23. PMID: 32202962