LATE POSTOPERATIVE FOLLOW-UP OF PATIENTS SUBMITTED TO SUBTOTAL SPLENECTOMY

Subtotal splenectomy preserving the upper splenic pole vascularized on ly by the splenogastric vessels has been performed by us in 91 patient s since 1984. This procedure was combined with central splenorenal shu nt or portal variceal disconnection to treating schistosomatic portal hypertension (n = 67); it was combined with distal pancreatectomy to t reat pancreatic cystadenoma (n = 1), and it was carried out for severe splenic trauma (n = 14), and to control severe Gaucher's disease (n = 4) and myeloid metaplasia due to myelofibrosis (n = 5). All patients are alive. In the present paper, we present the late postoperative fol low up of 32 patients operated in a period that ranges from 1 to 12 ye ars. All patients are satisfied with the operation. Increased counts o f white blood cell (n = 10) and platelets (n = 7) were the only hemato logical alterations. Esophageal varices were present in 23 of 27 patie nts operated due to portal hypertension, but all of them were shorter than in the preoperative period. The ultrasound confirmed the presence of the splenic remnant (30 of 32) without significant size changes. S plenic scintigraphies were positive in 30 of 32 patients. Subtotal spl enectomy seems to be a safe procedure that can be useful in portal hyp ertension, some metabolic and hematological diseases, and benign growt h of the distal pancreas.