Treatment program for patients with true splenic artery aneurysms in the surgical clinic of the Botkin hospital

Introduction. For many years the treatment of patients with true splenic artery aneurysms remained the prerogative of cardiovascular surgeons, but the development of minimally invasive surgical techniques has made it possible for hepatopancreatobiliary surgeons.

Materials and methods of research. We analyzed the results of treatment of 31 patients diagnosed with true splenic artery aneurysm who underwent surgical intervention in the surgical clinic of Botkin Hospital from 2020 to 2022. Laparoscopic clipping of aneurysm branches was performed in 29 (93,5 %) cases, in 1 (3,2 %) – laparoscopic splenectomy because of combined echinococcal affection of the spleen, one open clipping was done because of the simultaneous hepaticojejunoanastomosis formation. Evolution of surgical accesses was traced in the work as well as the analysis of immediate results of surgical interventions, general and specific postoperative complications according to Clavien-Dindo classification, and distant results were carried out.

Results. We analyzed 29 case histories of patients with true splenic artery aneurysms who underwent laparoscopic intervention. The surgical intervention time was 122,75 (60–240) minutes. Postoperative bed-day was 4,4 (2–8). Postoperative complications were revealed in two patients: in one case (3,2 %) we detected the development of acute posttraumatic pancreatitis, in the second – clinically significant spleen ischemia. Long-term results were traced in 19 patients, no recurrences of aneurysms as well as their recanalization were revealed in any case.

Conclusion. The modern approach to the treatment of true splenic artery aneurysms using laparoscopic techniques allows safe treatment of such patients with good long-term results.

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