Splenic salvage: A safe procedure.

ABSTRACT

Eighty five patients with splenic injury, 72 males and 13 females, 2-18 years of age, from the Department of Surgery, Siriraj Hospital, were managed by standard surgical procedure with an attempt to preserve the spleen. There were only 20 cases (23.53%) in which the splenic salvage succeeded, others had too much contraindication for splenic salvage. In the 20 cases, one had non-bleeding capsular tear, 14 underwent splenorrhaphy, 4 underwent partial splenectomy and splenic artery ligation was performed in one case. During a period of 2 years and 5 months, the success rate of the splenic salvage increased progressively from 10% in the first year to 33.3% in the last 5 months. In 65 cases of the splenectomy, 6 cases underwent splenic reimplantation without postoperative complication. Recently, the more conservative procedure is often performed instead of the splenectomy in all patients with splenic injury. Even one who undergoes splenectomy, splenic reimplantation also plays an alternative method in restoring normal protective function against the overwhelming post-splenectomy infection in selected case.