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What is the spleen, and what does it do?
The spleen, situated under the left rib cage near the stomach, is an important part of the immune system. The spleen contains special white blood cells that can destroy bacteria. It helps the body fight infections and also removes old red blood cells from the body’s circulation.
What is an open splenectomy?
An open splenectomy is a surgery to remove the entire spleen. Unlike a laparoscopic procedure, an open splenectomy requires a larger surgical cut. Patients with a very large or swollen spleen, or who are obese or have scar tissue in the spleen area from a previous operation. are considered for an open splenectomy.
How is an open splenectomy performed?
- An open splenectomy is a major surgery performed under general anesthesia. The surgeon makes an incision across the middle or left side of the abdomen underneath the rib cage.
- After locating the spleen, the surgeon disconnects it from the body’s blood supply and then removes it.
- The surgical openings are closed using stitches or sutures.
- When the spleen has been ruptured by severe injury, the surgeon approaches the organ from its underside and ties the splenic artery before removing the ruptured organ.
What happens if the spleen is removed?
Usually when the spleen is removed, other organs such as the liver can take over most of the functions of the spleen. But because the spleen is important for the body’s defense against germs, the patient is at a higher risk of infection after the operation.
Even without a spleen, the human body can cope with most infections, but there is a small risk that a serious infection (especially with certain bacteria) may develop quickly. Although these infections do not happen very often, they can be life-threatening. So, it is important to take precautions. This increased infection risk will be present for the rest of life.
Interestingly, however, about 30% of people have a second spleen (called an accessory spleen). These are usually very small, but may grow and function when the main spleen is removed.
What are the common complications after open splenectomy?
The most common complication after open splenectomy are fast-developing infections. The following are few other common complications.
- Blood clot in the vein that carries blood to the liver
- Hernia or infection at the operated site
- Inflammation of the pancreas (pancreatitis)
- Lung collapse
- Injury to the pancreas, stomach, and colon
How to prevent infections after splenectomy
A splenectomy makes a patient susceptible to infections, and below are a few preventive measures:
- To prevent infections, doctors recommend all immunizations two weeks prior or two weeks after the procedure.
- Usually the doctor recommends the flu shot every year post splenectomy.
- Children are placed on antibiotics every day until the age of 16 to prevent infections.
- Adults are only placed on antibiotics when they are sick or when they are on the verge of developing an infection.
- People who do not have a spleen who plan on traveling out of the country or to a place where medical help is not available can carry antibiotics to take as soon as they become sick.
