SHOULD REPEATED PARTIAL SPLENECTOMY BE ATTEMPTED IN PATIENTS WITH HEMATOLOGICAL DISEASES - TECHNICAL PITFALLS AND CAUSES OF FAILURE IN GAUCHERS-DISEASE

Background/Purpose: The awareness of the risk of overwhelming sepsis a fter splenectomy prompted surgeons to attempt splenic preservation in patients who had hematologic diseases for which splenectomy was the co nventional treatment. Partial splenectomy for Gaucher's disease was wi dely performed before the introduction of alglucerase. In sporadic cas es a second partial splenectomy had also been attempted. Methods: The authors present three cases of failed repeated partial splenectomy att empted before alglucerase was available. The role of angiography in pl anning operative strategy and the surgical pitfalls of this unusual re intervention are discussed. Conclusion: New indications for partial sp lenectomy in other hematologic diseases makes the experience gained wi th Gaucher's disease valuable for management decisions. Copyright (C) 1997 by W.B. Saunders Company.