The impact of splenic weight on laparoscopic splenectomy for splenomegaly

Background: Enlarged spleens increase the technical difficulties associated with laparoscopic splenectomy (LS). The aim of this study was to analyze the impact of splenic weight on the results of LS. Methods: We performed a prospective analysis of 20 LS for splenomegaly and 40 LS for normal spleen in terms of intraoperative and early postoperative outcome. Results: Patients with splenomegaly had longer operative times and higher conversion and transfusion rates than those with nor-mat spleens. Patients with spleens weighing < 2000 g experienced less blood loss, fewer conversions, and a shorter postoperative hospital stay than those with spleens > 2000 g. No differences-except for the longer operative time-were observed between normal-sized spleens and those weighing < 2000 g. Conclusions: LS for splenomegaly is feasible for experienced laparoscopic surgeons. For spleens weighing < 2000 g, the outcome was comparable to that of normal spleens. whereas LS for spleens > 2000 g was associated with a higher conversion rate, greater blood loss, a longer hospital stay, and increased morbidity.