Intra-abdominal abscess and an intractable abdominal wall sinus forty years after splenectomy is rare, which has not been described previously in the surgical literature. We report the management of a patient who had presented with an intractable sinus on his left hypochondrium forty years after having undergone splenectomy and cholecystectomy, which persisted for more than two years despite re...

Distal pancreatectomy with en-bloc splenectomy has been considered the standard technique for management of benign and malignant pancreatic disorders. However, splenic preservation has recently been advocated. The aim of this study was to review the experiences of distal pancreatectomy using the open or the laparoscopic approach and to critically discuss the need to perform splenectomy. Origina...

HYPOTHESIS Hand-assisted laparoscopic surgery (HALS) is a safe therapeutic approach to remove megaspleens of any size. Conventional laparoscopic splenectomy for splenomegaly is difficult because of limited exposure and complex vascular control, with increased risk of intraoperative bleeding and conversion to open surgery. HALS can overcome some of these limitations, reducing the risk of convers...

BACKGROUND Laparoscopic splenectomy of normal-sized spleens or in moderate splenomegaly is performed with increasing frequency. By using a modification of the open laparotomy, minimal-access splenectomy is an attractive alternative in severe splenomegaly. METHODS Between September 2002 and October 2003, 9 patients (mean age, 58.8 years; range, 41 to 72) with severe splenomegaly (mean length, ...

We report three patients with splenic abscess whom we attempted to treat without recourse to open surgery. Medical treatment alone was successful in one case, and medical treatment combined with percutaneous drainage was successful in the second. Splenectomy was required in the third case after failure of medical treatment and complications of percutaneous drainage. The difficulties in diagnosi...

The article by Arce and others was helpful. However, in cases of giant splenic hydatid cyst, splenectomy or partial splenectomy is generally considered the preferred treatment rather than removal of the cyst, as reported by Rashid and others. If there is more than one cyst, a large cyst, a cyst in a deep organ location, or an infected cyst, open surgery should be done. I agree with Arce and oth...

BACKGROUND Laparoscopic splenectomy (LS) has several advantages over the open procedure but can be technically demanding when performed in patients with massive splenomegaly. We hypothesized that patients who undergo hand-assisted LS (HALS) may experience the benefits of LS while having their enlarged spleens removed safely. METHODS We reviewed the charts of patients who underwent HALS or LS ...

BACKGROUND AND OBJECTIVES Given the technical difficulty of laparoscopic splenectomy and azygoportal disconnection (LSD), data are limited that compare the laparoscopic to the open procedure. As the technique becomes more widespread, questions regarding its safety, feasibility, and reproducibility must be addressed. This review assesses the current status of LSD. METHODS We conducted our lite...