Splenectomy Patient Information

A splenectomy is the partial or complete removal of the spleen, a bean-shaped organ that plays an essential role in the body's immune response. The spleen is located behind the rib cage, in the upper left abdominal area. Only a well-trained and highly experienced surgeon should perform splenectomies due to the procedure's high rate of complications.

Significance

• Splenectomy is a fairly common procedure for both children and adults in the United States. Removal of the spleen is major surgical procedure with lifelong effects. The spleen is a vital part of the immune system and works to filter impurities from the blood, regulate blood flow to the liver, remove old blood cells from the body and store new blood cells. Without a working spleen, the body is vulnerable to infection from sources that pose little threat to those with a healthy immune system. Even with this risk, splenectomies are life-saving procedures for many people.

Reasons for Splenectomy

• Splenectomies are done for a variety of reasons. Most splenectomies are performed when a patient is diagnosed with hypersplenism, a syndrome that causes spleen enlargement, blood cell defects and a high rate of blood cell turnover. Cancer of the spleen and a disease called hereditary spherocytosis always require removal of the spleen. In other cases, such as when a patient is suffering from idiopathic thrombocytopenic purpura, rupture of the splenic artery or hereditary elliptocytosis, a splenectomy is often the treatment of choice but is not always urgently needed. Trauma, blood clots, liver cirrhosis, abscesses, Hodgkin's lymphoma, thalassemia, myelofibrosis and autoimmune hemolytic disorders are other reasons for splenectomy.

Types of Splenectomy Procedures

• The three types of splenectomy procedures are: complete splenectomy, partial splenectomy and laparoscopic splenectomy. In complete splenectomies, the entire spleen is removed under general anesthesia. This procedure is generally performed in cases of hypersplenism and ruptured spleens. Partial splenectomies may be performed to leave part of the spleen intact in order to decrease the patient's vulnerability to infection following surgery. Laparoscopic splenectomy involves removing the spleen through multiple, smaller incision. Laparoscopic splenectomies have a lower risk of infection, cause less postoperative pain, and typically require a shorter hospital stay.

Recovery

• Recovery time following a splenectomy can be extensive. Medications are prescribed to reduce pain and prevent infection, and patients must take excellent care of their surgical wound due to an impaired immune system. Blood transfusions may be needed for some patients to replace lost blood or defective blood cells. The risk of potentially serious infections in splenectomy patients is high. Any fever or sign of infection is considered a medical emergency, and many children who undergo a splenectomy remain on preventative antibiotics until they are at least 16 years of age.

Complications

• Splenectomies are complicated procedures with numerous risks. According to the National Institutes of Health, a potentially fatal condition called postsplenectomy sepsis may develop following surgical removal of the spleen. The risk of death is highest for the first two years following surgery, and children are especially vulnerable to the condition. Other possible complications include pancreatic inflammation, lung collapse, excessive bleeding, blood clots and infection of the incision. To reduce the risk of long-term complications, anyone preparing to undergo a splenectomy should be vaccinated against pneumococcal, meningococcal and Haemophilis influenza diseases.