Post-Splenectomy Complications and Outcomes: A Retrospective Cohort Study

This retrospective cohort study evaluated the complications and outcomes of 174 patients who underwent splenectomy between 2011 and 2021 at hospitals affiliated with Babol University of Medical Sciences. The cohort had a mean age of 33.81 ± 12.45 years, with a male predominance (57.47% males and 42.52% females). Indications for splenectomy were categorized into trauma (32.18%), hematological disorders (54.02%), and other conditions. The study assessed short-term complications (e.g., surgical site infection, pleural effusion, and subphrenic abscess) and long-term complications (e.g., overwhelming post-splenectomy infection [OPSI], pulmonary hypertension [PH], and thromboembolic events). Postoperative complications were observed in 14.36% of patients, with infectious complications being the most common (7.47%). OPSI occurred in 1.72% of cases, with a high associated mortality rate of 66.66%. Portal vein thrombosis (PVT) was identified in 1.72% of patients, all of whom underwent open splenectomy. Comparative analysis revealed no statistically significant differences in complication rates between open and laparoscopic splenectomy or between emergency and elective surgeries. Vaccination status against encapsulated organisms did not significantly correlate with the incidence of infectious complications. These findings highlight the importance of monitoring, particularly for infectious and thromboembolic complications post-splenectomy, especially in patients with hematological disorders. The study underscores the need for tailored postoperative care, including adherence to vaccination protocols and the use of anticoagulation therapy, to reduce the morbidity and mortality risks associated with splenectomy.