Tufail M, Majid N J, Dar H M, Javed A.
Splenectomy — a six years experience.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;17(1):39-45.

The complete medical records of 100 patients undergoing splenectomy over a 6 years period (June 1992 -December 1998) for various conditions at Surgical Unit II, Shaikh Zayed Hospital, Lahore, were reviewed. Of these 100 patients, there were 57 males and 43 females. The median age was 35 years (range 8 - 70 years). Spleen was severely enlarged (>20cm) in 45 cases, of moderate size (11 - 20cm) in 6 cases and of normal size in 49 cases. Average weight of the spleen reported after histopathology was 450gm (range 150gm - 2.6 Kg). The overall complication and mortality rates were 21% and 7% respectively. Of the 7 patients who died, 6 patients (85.71%) were cirrhotics. Among these, highest mortality was seen in the patients belonging to Child`s grade C (57.1%) and those patients who underwent splenectomy in the emergency setting as an additional procedure along with gastro-oesophageal devascularization for upper gastro-intestinal variceal bleeding (71.4%). The syndrome of Overwhelming Post Splenectomy Infection (OP SI) was not seen in any of our patients. Removal of a massively enlarged spleen with pronounced hypersplenism, especially in portal hypertension, can be taxing for even an experienced surgeon. The operation should be performed by a senior and experienced member of the surgical team. However, the large weight of the spleen does not constitute a contraindication to splenectomy, but indications must he carefully selected, and the operative and peri-operative management, must be appropriate.

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