SHOULD REPEATED PARTIAL SPLENECTOMY BE ATTEMPTED IN PATIENTS WITH HEMATOLOGICAL DISEASES - TECHNICAL PITFALLS AND CAUSES OF FAILURE IN GAUCHERS-DISEASE
E. Freud et al., SHOULD REPEATED PARTIAL SPLENECTOMY BE ATTEMPTED IN PATIENTS WITH HEMATOLOGICAL DISEASES - TECHNICAL PITFALLS AND CAUSES OF FAILURE IN GAUCHERS-DISEASE, Journal of pediatric surgery, 32(9), 1997, pp. 1272-1276
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.