doiSerbia

Laparoscopic technique as a method of choice in the treatment of non-parasitic splenic cysts

Milosavljević Vladimir (Stefan Visoki General Hospital, Smederevska Palanka)
Tadić Boris (Clinical Centre of Serbia, First Surgical Clinic, Clinic for Digestive Surgery, Belgrade)
Grubor Nikola (Clinical Centre of Serbia, First Surgical Clinic, Clinic for Digestive Surgery, Belgrade)
Erić Dragan (Institute of Nuclear Sciences, Belgrade)
Matić Slavko (Clinical Centre of Serbia, First Surgical Clinic, Clinic for Digestive Surgery, Belgrade)

Introduction/Objective. Splenic cysts are a rare clinical entity. In their origin, they may be parasitic or non-parasitic. They are classified as either primary (true) or secondary cysts (pseudocysts), depending on the presence or absence of an epithelial lining of the lumen. Methods. Using a retrospective case study, we included 29 patients undergoing laparoscopic surgery due to splenic cysts. The patients were treated within the 2007–2017 period at the Clinic for Digestive Surgery, the Clinical Center of Serbia. We analyzed pre-operative, intra-operative and post-operative characteristics of laparoscopic technique in treating non-parasitic splenic cysts. Results. The group of 29 patients treated with laparoscopic technique surgery due to the previously diagnosed splenic cyst, consisted of 12 (41.4%) men and 17 (58.6%) women. The average age of patients undergoing surgery was 38.86 ± 10.4 years (22–62). Based on the histopathological findings, there were eight epithelial cysts and 21 pseudocysts of the spleen. The maximal diameter of the splenic cyst, measured pre-operatively, was 10.09 ± 2.51 cm on average. The average operative time was 35 minutes, and the intra-operative bleeding amount was 11.48 ± 3.78 ml. None of the intra-operative complications, injury to the spleen or other organs of the abdomen, conversions to open surgery or reintervention were recorded. Conclusion. Laparoscopic fenestration with excision of the part of the spleen cyst wall (marsupialization) represents an effective and definitive treatment for this disease. It is an alternative to splenectomy, along with other well-known benefits ensured by the spleen preservation. Low probability of occurrence of intra-operative and post-operative complications, as well as minimal trauma of tissue, results in a shorter postoperative stay, rapid recovery, and better quality of life.

Keywords: cyst, spleen, laparoscopy, laparoscopic technique