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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2021; 75(2): 134–137. doi: 10.48095/ccgh2021134.

Laparoscopic or classic splenectomy?

Aleš Zatloukal1, Anton Pelikán1,2, Peter Ihnát1

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With current development of mini-invasive techniques, laparoscopic splenectomy also gained its place under the sun. The goal of this study is to compare the results of open and laparoscopic splenectomy performed at Clinic of Surgery of University Hospital Ostrava in the period 2010–2019.

Materials and Methods:

A retrospective cohort study during the period 2010–2019 were counted: an operation time, a need of blood transfusions, weight, complications and duration of hospital stay. A group of patients with laparoscopic operation was compared to a group with an open operation, using the t-test.


During the period 2010–2019, we performed 23 laparoscopic splenectomies and 15 classic operations. Unfortunately, the comparison of both groups is difficult. The splenic weight differs in both groups statistically significantly (P = 0.0001). The patients in the classic laparotomy group had much bigger spleens and in four cases, the splenectomy was performed together with metastasectomy of the liver, diaphragmatic resection and resection of the tale of pancreas. Even then the operative time was significantly shorter than the operative time of laparoscopic operation – the operative times differ in both groups statistically significantly (P = 0.0001). The need of blood transfusion and operative complications appear to be comparable in both techniques. The duration of hospital stay was shorter in the patients with laparoscopic operation.


Laparoscopic splenectomy off ers all the general benefi ts of mini-invasive operative techniques and is suitable method for patients undergoing elective splenectomy especially for spleens smaller than 20 cm in diameter. We consider portal hypertension and severe comorbidities of the patient to be a contraindication. It seems to us that the main problem of this method lies in a very small number of operated patients and thus in a limited possibility to obtain sufficient surgical erudition, which is probably the case of some complications and insufficient use of this method in practice. It is highly desirable to concentrate these services in the centers.


laparoskopická splenektomie, otevřená splenektomie, complication

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1. Habermalz B, Sauerland S, Decker G et al. Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc 2008; 22(4): 821–848. doi: 10.1007/s00464-007-9735-5.
2. Dixon S, Horgan LF. The elusive spleen Ann R Coll Surg Engl. 2019; 101(3): 176–179. doi: 10.1308/rcsann.2018.0215.
3. Ermolov AS, Tlibekova MA, Yartsev PA et al. Laparoscopic splenectomy in patients with spleen injuries. Surg Laparosc Endosc Percutan Tech 2015; 25(6): 483–486. doi: 10.1097/SLE.0000000000000207.
4. Martínek L, Zonča P, Guňka I. Komplikace laparoskopické splenektomie. Rozhl Chir 2013; 92(2): 112–114. 5. Cheng J, Tao K, Yu P. Laparoscopic splenectomy is a better surgical approach for spleen-relevant disorders: a comprehensive meta-analysis based on 15-year literatures. Surg Endosc 2016; 30(10): 4575–4588. doi: 10.1007/ s00464-016-4795-z.
6. Borie F. Laparoscopic partial splenectomy: Surgical technice. J  Visc Surg 2016; 153(5): 371–376. doi: 10.1016/j.jviscsurg.2016.05.002.
7. Héry G, Becmeur F, Méfat L et al. Laparocopic partial splenectomy: indications and results of a multicenter retrospective study. Surg Endoscs 2008; 22(1): 45–49. doi: 10.1007/s00464-007-9509-0.
8. Barbaros U, Dinççağ A. Single incision laparoscopic splenectomy: the first two cases. J Gastrointest Surg 2009; 13(8): 1520–1523. doi: 10.1007/s11605-009-0869-8.
9. Somasundaram SK, Massey L, Gooch D et al. Laparoscopic splenectomy is emerging‚ gold standard‘ treatment even for massive spleens. Ann R Coll Surg Engl 2015; 97(5): 345–348. doi: 10.1308/003588414X14055925060479.
10. Feng S, Qiu Y, Li X et al. Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis. Pediatr Surg Int 2016; 32(3): 253–259. doi: 10.1007/s00383-015-3845-2.
11. Ai-raimi K, Zheng SS, Postoperative outcomes after open splenectomy versus laparoscopic splenectomy in cirrhotic patients: a meta-analysis. Hepatobiliary Pancreat Dis Int 2016; 15(1): 14–20. doi: 10.1016/s1499-3872(16)60053-x.
12. Vecchio R, Intagliata E. Lateral versus anterior approach for laparoscopic splenectomy. Surg Laparosc Endosc Percutan Tech 2019; 29(4): 308. doi: 10.1097/SLE. 000000000000671.
13. Huang D, Tao M, Cao L C et al. Risk factors and anticoagulation effects of portal vein system thrombosis ater laparoscopic splenectomy in patiens with or without cirrhosis. Surg Laparosc Endosc Percutan Tech 2019; 29(6): 498–502. doi: 10.1097/SLE.0000000000000710.
14. Zonča P. Bužga M, Ihnát P et al. Retroperitoneoscopic adrenalectomy in obese patients: is it suitable? Obes Surg 2015; 25(7): 1203–1208. doi: 10.1007/s11695-014-1475-8.
15. Matharoo GS, Afthinos JN, Gibbs KE. Trends in splenectomy: where does laparoscopy stand? JSLS 2014; 18(4): e2014.00239. doi: 10.4293/JSLS. 2014.00239.
16. Mýtnik M, Pastierik P, Šeliga P. Laparoskopická splenektómia-naše skúsenosti. Rozhl Chir 2009; 88(1): 7–10.
17. Vokurka S, Koza V, Vozobulová V  et al. Výsledky a komplikace splenektomie u pacientů s těžkou trombocytopenií při ITP rezistentní na úvodní konzervativní léčbu-zkušenosti centra. Transfuze Hematol dnes 2007; 1: 23–26.
18. Kvapil F, Doubek M, Brychtová Y et al. Splenektomie v  diagnostice a  léčbě hematologických onemocnění-indikace, komplikace a  výsledky z jednoho pracoviště. Transfuze Hematol dnes 2006; 3: 146–152.
19. Martínek L, Dostalík J, Guňková P et al. Laparoskopická splenektomie. Minivaziv Chir 2008; 4: 11–14.
20. Šváb J, Krška Z, Gürlich R et al. Laparoskopická splenektomie - vlatní zkušenosti. Rozhl Chir 2002; 81(10): 523–526.

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