LAPAROSCOPIC SPLENECTOMY FOR IDIOPATHIC THROMBOCYTOPENIC PURPURA

Laparoscopic splenectomy was performed on eight patients with idiopath ic thrombocytopenic purpura refractory to medical treatment. Preoperat ive infusion of immunoglobulin G gamma-globulin was used to boose the platelet count. Accessory spleens were sought by preoperative computed tomography and peroperative examination of the usual anatomical locat ions. Seven patients underwent successful laparoscopic splenectomy, wi th a mean postoperative stay of 3.6 days. One patient with an accessor y spleen detected before operation but not during laparoscopy required conversion to open surgery for control of haemorrhage from the spleni c hilum. Another patient had a transient pancreatic fistula. Laparosco pic splenectomy is feasible and safe in patients with idiopathic throm bocytopenic purpura. Long-term results require evaluation as detection of accessory spleens can prove difficult during laparoscopy.