Management of splenic artery injury during laparoscopic radical gastrectomy: a case report and review of the literature

Splenic artery injury during laparoscopic radical gastrectomy poses significant risks of perioperative complications and impaired splenic function, yet standardized management strategies remain underreported. This work aims to guide clinicians in optimizing intraoperative decision-making for splenic artery injury while emphasizing the need for tailored strategies based on anatomic and hemodynamic contexts. This study presents a case of intraoperative splenic artery injury in a Chinese Han patient with gastric cancer undergoing laparoscopic radical total gastrectomy, where the ligamentum teres hepatis was innovatively utilized to envelop the vascular anastomosis, thereby shielding it from digestive fluid erosion and preventing postoperative hemorrhage. The patient exhibited uneventful recovery with no delayed bleeding or splenic ischemia. Implementing an effective management strategy for the splenic artery after injury significantly enhances surgical outcomes. The novel application of ligamentum teres hepatis wrapping demonstrates potential as a protective adjunct for vascular anastomoses in upper gastrointestinal surgery; however, its efficacy requires validation through larger prospective studies.