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Functions of the splenic remnant after subtotal splenectomy for treatment of severe splenic injuries

PURPOSE: To evaluate clinical and laboratory variables in patients submitted to subtotal splenectomy. METHODS: 34 patients with severe trauma of the spleen and its pedicle were studied: 25 patients were submitted to subtotal splenectomy, preserving only the upper pole of the spleen (Group I), 9 were submitted to total splenectomy (Group II), and other 22 people with intact spleen were the control (Group III). Immediate and late postoperative complications were investigated. Laboratory exams were performed in the late postoperative period (red blood cells, hemoglobin, white blood cells, platelets and Howell-Jolly bodies). We studied the B- and T-lymphocyte counts and the immunoglobulins A, G and M (IgA, IgG and IgM) levels. Splenic scintigraphy with technetium 99mTc sulfur colloid was carried out on all patients. RESULTS: Group II presented Howell-Jolly bodies increased and low level of immunoglobulin M. The splenic scintigraphy demonstrated the viability and the filtering function of the splenic remnant in Group I . CONCLUSIONS: Subtotal splenectomy is a surgical alternative technique for treatment of severe distal injuries of the spleen or when its main vessels are damaged.

Spleen; Splenectomy; Spleen; Spleen


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