Splenectomy is the surgical removal of part or all of the spleen.
Indications for splenectomy
- Idiopathic thrombocytopaenia Purpura (ITP) – low platelet counts leading to bleeding tendency.
- Splenomegaly (enlarged spleen) secondary to lymphoma.
- In conjunction with distal pancreatectomy for pancreatic mass/ tumour, with splenic colon cancer or left renal cancer.
- Splenic tumour (primary or secondary).
- Splenic trauma.
Splenectomy is performed either as an open or laparoscopic approach, depending on indications and size of the spleen. Except in a case of massive spleen, laparoscopic splenectomy is the most common method.
Preoperative vaccinations against haemophilus, meningococcal and pneumococcal organisms will be required 1-2 weeks prior to splenectomy.
Complications of splenectomy include:
- Pancreatic leak.
- Wound infections.
- OPSI (Overwhelming Post-splenectomy Infection) – rare severe infections post splenectomy.
After splenectomy, a patient will require at least 3 years of prophylactic oral antibiotics, such as 500mg Amoxicillin daily to prevent the risk of OPSI. In case of infections, early review with doctors and immediate treatment with antibiotics are necessary. All splenectomy patients are referred to Victorian Spleen Registry:
Where possible a small section of the spleen is sometimes left in place to continue to provide some of the spleen's protective role against bacterial infections.