Subtotal cystectomy with laparoscopic splenic preservation
Epublication WebSurg.com, Mar 2017;17(03). URL: http://websurg.com/doi/vd01en4835
Non-parasitic splenic lesions are a rare entity. Since they can generate signs and abdominal symptoms and cause many complications, their detection requires some form of treatment. The possibility of post-splenectomy fatal sepsis has led to the search for new therapeutic alternatives which simultaneously ensure the healing process and preserve the splenic tissue. The preservation of at least 25% of splenic tissue provides protection against pneumococcal bacteremia. One of the techniques used is partial cyst decapsulation with splenic preservation. We report the case of a 17-year-old woman who was incidentally diagnosed with a 4cm splenic cystic with negative serological studies and tumor markers suggestive of an epidermal cyst. Radiological monitoring of the lesion is performed and a cystic growth of 7cm is observed. As a result, surgery is decided upon. At laparoscopy, a splenic cyst of 7cm in diameter is found. However, it does not affect the splenic vessels. Lancing and draining the cyst is made and partial cyst decapsulation is performed with splenic preservation. The patient made an uneventful recovery. Partial decapsulation of the cyst’s wall offers several advantages: it is technically easier to perform, involves minimal blood loss, it preserves the entire splenic tissue and has a high cure rate. It is an excellent therapeutic alternative for young people with splenic cysts because it eliminates the disease process without loss of splenic tissue and it is minimally invasive for the patient.