Planning the partial splenectomy

Assuming that the spleen is appropriately placed for full evaluation and that hemostasis is adequate, the planning for partial splenectomy can start. In trauma cases, it will be dictated by the extent of the injury and in elective cases by the nature of the underlying pathology.

The spleen in the majority of cases can be divided into independent lobes or segments, each with its own terminal blood supply (A, B). The superior pole is supplied by the short gastric vessels and the lower pole by branches of the gastroepiploic artery (up to five) known to anastomose with the inferior polar artery. In addition, most patients, despite possible variations, have two or three major vessels entering the hilum. Therefore there are usually four or five regions or lobes available for partial splenec-tomy. It is also important to understand that these vessels lie in different supportive ligaments. Vessels to the superior pole (short gastrics) and inferior pole (gastroepiploic branches) rest in the gastrosplenic ligament, whereas the splenic branches proper lie in the splenorenal ligament with the tail of the pancreas.

Partial Splenectomy

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