Pediatric splenectomy for hematologic disorders: two-decade experience and prophylactic cholecystectomy outcomes

Splenectomy offers durable improvements in hematologic parameters across various hematologic diseases, with minimal complications. Prophylactic cholecystectomy appears justified in patients with marked hyperbilirubinemia, even without cholelithiasis, particularly in hereditary spherocytosis. The absence of post-splenectomy sepsis in this series supports the continued role of total splenectomy when appropriate vaccination protocols and antibiotic prophylaxis are implemented.