Laparoscopic resection of giant splenic artery aneurysm with spleen and pancreas preservation: a retrospective case series

Splenic artery aneurysm (SAA) larger than 5 cm are extremely rare, and they are considered to be giant. Its management options have expanded with advances in minimally invasive techniques. However, reports on laparoscopy for SAA resection are limited. This article describes our experience performing laparoscopic resection with spleen and pancreas preservation to treat SAA. Data from 11 patients who underwent laparoscopic resection with spleen and pancreas preservation of SAA in our hospital from March 2020 to May 2023 were included in our research with respect to surgical outcomes, safety, and utility. All the procedures were successfully carried out laparoscopically. The median age was 52.00 (45.00, 60.00) years. The median operation time and median blood loss were 200.00 (187.50, 210.00) minutes and 260 (180, 300) ml,, respectively. After surgery, all patients had pathologically confirmed saccular splenic artery. Postoperative complications including subphrenic or perisplenic fluid collection, pneumonia and intra-abdominal bleeding occurred and responded well to conservative treatment. There were no cases of pancreatitis, pancreatic fistula, splenic infarction or platelet abnormalit in this series. The median covery of bowel function timed was 3.0 (2.0, 3.0) days. The median postoperative abdominal drainage tube carrying time was 3.0 (2.0, 4.0) days. The median length of hospital stay was 7 (7.0, 9.0) days. There was no obvious abnormality during outpatient follow-up examination. Laparoscopic resection appears to be a safe and technically feasible approach for the management of selected giant SAAs, with the advantage of organ preservation in this small case series. Comparative studies with larger sample sizes are needed to determine the relative advantages of laparoscopic resection versus endovascular or open approaches.