Laparoscopic distal pancreatectomy and splenectomy for splenic artery aneurysm

Rationale:Splenic artery aneurysm (SAA) is the most common visceral artery aneurysm, while most SAAs are treated by endovascular or open procedures.Patient concerns:Here we present a case of SAA treated by laparoscopic aneurysmectomy with end-to-end anastomosis.Diagnoses:A 40-year-old woman was incidentally found to have an asymptomatic distal SAA. CT scan revealed the SAA to be located at the hilum of the spleen, with a maximal diameter of 2.7 cm.Interventions:To prevent sudden rupture, the patient received laparoscopic aneurysmectomy. During the operation, end-to-end anastomosis was also performed since a tortuous proximal splenic artery prevented delivery of the stent graft.Outcomes:The patient was ambulated 12 hours after surgery and discharged 5 days later. Postoperative recovery was smooth without hemorrhage, infarction, infection, or splenic artery thrombosis. At 10-month follow-up,no hemorrhage, aneurysm recurrence, spleen infarction, splenic artery stenosis, or thrombosis had occurred.Lessons:Patients with distal SAA can be treated by laparoscopic aneurysmectomy with end-to-end anastomosis to preserve the spleen. The laparoscopic procedure is safe and feasible in the selected patients.

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“…[3] Sometimes, distal SAAs further necessitate pancreatectomy if the aneurysm is too closely adherent to the tail of pancreas. [10] …”

Section: Discussionmentioning

confidence: 99%

Treatment of distal splenic artery aneurysm by laparoscopic aneurysmectomy with end-to-end anastomosis

et al. 2017

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“…Recently, laparoscopic surgery has been increasingly accepted as a surgical approach to treat unruptured visceral artery aneurysms when transcatheter arterial embolization is impossible . Laparoscopic surgery for visceral artery aneurysms has been performed in 55 cases (Table ) . Resection of the aneurysm, including the adjacent organ, was performed in 51 of these cases (93%); the remaining four patients underwent ligation of the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic surgery for the treatment of a ruptured aneurysm of the right gastric artery: a case report

Toyoda¹,

Kyokane²,

Kawai³

et al. 2016

Asian J Endoscop Surgery

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Laparoscopic surgery for the treatment of a ruptured visceral artery aneurysm is recognized as a challenging procedure. Here, we describe our experience with laparoscopic surgery to treat a ruptured aneurysm of the right gastric artery. A 72-year-old woman was diagnosed with intra-abdominal hemorrhage caused by a ruptured aneurysm of the right gastric artery. Transcatheter arterial embolization failed because the right gastric artery could not be cannulated. Therefore, we performed laparoscopic surgery. Using laparoscopy, we detected that the bleeding from the aneurysm had ceased; thus, the planned procedure was successful. The operative time and intraoperative blood loss were 100 min and 5 mL, respectively. The patient was discharged 7 days after surgery. Laparoscopic surgery after the failure of transcatheter arterial embolization is a suitable and safe procedure for ruptured visceral artery aneurysms, provided the circulatory dynamics are stable as a result of the temporary cessation of bleeding from the ruptured aneurysm.

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“…It cannot, however, be guaranteed that the spleen will be unaffected 3,9 . Open surgery procedures can also be conducted with good results and less invasiveness using videolaparoscopic surgery 10,11 with the use of staplers, but this demands training in intraoperative ultrasound and should not be used with patients who are hemodynamically unstable or when there are signs of rupture 6 .…”

Section: Discussionmentioning

confidence: 99%

Aneurisma sacular de arteria esplenica: tratamento endovascular ou cirurgico convencional?

et al. 2013

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Laparoscopic distal pancreatectomy and splenectomy for splenic artery aneurysm

Cited by 9 publications

References 23 publications

Treatment of distal splenic artery aneurysm by laparoscopic aneurysmectomy with end-to-end anastomosis

Treatment of distal splenic artery aneurysm by laparoscopic aneurysmectomy with end-to-end anastomosis

Laparoscopic surgery for the treatment of a ruptured aneurysm of the right gastric artery: a case report

Aneurisma sacular de arteria esplenica: tratamento endovascular ou cirurgico convencional?

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