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Laparoscopic partial splenic resection in hydatid disease

Laparoskopische Milzteilresektion bei einer Echinokokkuszyste

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Zusammenfassung

GRUNDLAGEN: Die laparoskopische Teilresektion der Milz ist ein sicherer und effektiver Eingriff. Parasitäre Milzzysten sind selten, und es gibt in der Literatur nur wenige Daten über ihre laparoskopische Behandlung. Allgemein herrscht die Meinung, dass eine Milz mit einer parasitären Zyste in toto entfernt werden sollte, um eine akzidentelle intraoperative Öffnung der Zyste und eine mögliche peritoneale Kontamination zu vermeiden. METHODIK: Wir berichten über den ersten Fall einer laparoskopischen Milzteilresektion bei einem 15-jährigen Jungen mit einer Echinokokkuszyste der Milz. ERGEBNISSE: Obwohl in der Literatur zur Behandlung von Echinokokkuszysten der Milz eine totale Splenektomie empfohlen wird, haben wir nach 13 Monaten nach einer laparoskopischen Milzteilresektion wegen Echinokokkuszyste keine Komplikationen feststellen können. Somit gilt die Erkrankung als verheilt. SCHLUSSFOLGERUNGEN: Im Gegensatz zur herrschenden Meinung konnten wir feststellen, dass die laparoskopische Milzteilresektion eine Möglichkeit zur Behandlung von Echinokokkuszysten der Milz darstellt. Einerseits werden durch die Teilresektion die wichtigen immunologischen Funktionen der Milz erhalten und andererseits kommen dem Patienten die Vorteile der minimal invasiven Operation wie weniger Schmerzen und ein besseres kosmetisches Ergebnis zugute.

Summary

BACKGROUND: Laparoscopic partial splenectomy is a safe and effective procedure for splenic surgery. Parasitic splenic cysts are rare and there are few reports of their laparoscopic treatment. The general opinion is that spleens with parasitic cysts should be excised in toto to avoid accidental intraoperative opening of the cyst and possible intraperitoneal infection. METHODS: We present the first case of laparoscopic partial splenectomy in a 15-year-old boy with splenic hydatid cyst. In addition, we review the current literature to evaluate the results of different surgical techniques for the treatment of splenic hydatid cysts. RESULTS: The literature notwithstanding, we have not encountered any complications in 13 months' postoperative follow-up. CONCLUSIONS: In contrast to prevailing opinion, we find that laparoscopic partial splenectomy can be seen as an option to treat splenic hydatid cysts while preserving splenic immunologic functions and causing less pain and better cosmetic results.

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Authors and Affiliations

  1. Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey

    G. Bas, O. Alimoglu & M. Sahin

  2. Department of Surgery, Medical University of Graz, Graz, Austria

    S. Uranues

Authors
  1. G. Bas
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  2. O. Alimoglu
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  3. M. Sahin
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  4. S. Uranues
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Correspondence to S. Uranues.

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Bas, G., Alimoglu, O., Sahin, M. et al. Laparoscopic partial splenic resection in hydatid disease. Eur Surg 41, 90–93 (2009). https://doi.org/10.1007/s10353-009-0458-9

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  • DOI: https://doi.org/10.1007/s10353-009-0458-9

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