A Quarter Century With Splenectomy

Abstract

Twenty-five years in surgery of the spleen is summarized in 1,944 patients who have been operated on for hypersplenism (48%), other splenic disease (9%), Hodgkin staging (4%), trauma (10%), and the increasing number with splenectomy incidental (29%) to gastrointestinal disease, hepatic disease, or transplantation. This experience focuses on changing trends in hematological indications including Hodgkin staging, leukemic reticuloendotheliosis, and myelofibrosis; current concepts in patient selection based on splenic sequestration; adjuncts to operative management, and the continuing challenge to prevent surgical complications and lower mortality.