Comparative Study between Proximal and Distal Ligation of Splenic Artery during Open Splenectomy and its Effect on Intraoperative and Postoperative Complications.

Document Type : Original Article

Authors

1 Department of General and Hepatobiliary Surgery, Faculty of Medicine, Ain Shams University, Egypt

2 Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

Abstract

Introduction: Splenectomy, the surgical removal of the spleen, is performed for various hematologic, infectious, 
inflammatory, neoplastic, and traumatic conditions. Understanding the anatomy and physiology of the spleen,    
particularly the course of the splenic artery that supplies the spleen is crucial for surgical planning. The choice 
between proximal and distal ligation of the splenic artery during open splenectomy has been a subject of clinical 
investigation. 
Aim of work: This study aims to assess the outcomes and effects of proximal versus distal ligation of the splenic 
artery on intraoperative and postoperative complications during open splenectomy.
Patient and methods: A retrospective study was conducted at Ain Shams University Hospitals between January 
and August 2024 to evaluate the effects of proximal versus distal ligation of the splenic artery on intraoperative    
and postoperative outcomes. The study included 50 patients (29 in distal ligation group ,21 at proximal group).
Results: The study’s key findings revealed that the proximal ligation group had a statistically significant reduction    
in operative time (P=0.023) and shorter hospital stays (P<0.05) compared to the distal ligation group. Additionally,    
the distal ligation group experienced higher postoperative wound infection rates (P=0.001) and an increased risk 
of postoperative pancreatic fistula (POPF) occurrence (P<0.05). No significant differences were observed between    
the groups regarding intraoperative hemorrhage (P=0.114) or postoperative hemorrhage (P=0.235). 
Conclusion: Our findings suggest that proximal splenic artery ligation is associated with shorter operative time 
and lower wound infection rates without increasing intraoperative or postoperative complications. While the risk of 
POPF was higher in the distal ligation group.

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