A novel therapeutic approach to non-parasitic splenic cysts: laparoscopic fenestration and endothelium obliteration.

Splenic cyst is a relatively rare disease; true splenic cysts are classified as parasitic and non-parasitic cysts. Although most cysts are asymptomatic, large cyst cases show clinical symptoms, consisting mainly of dyspepsia and fullness in the upper left abdomen. Surgical intervention is recommended primarily for large cysts to prevent complications such as rupture, hemorrhage, and infection. This paper presents our experience of eleven laparoscopic procedures for non-parasitic splenic cysts. Laparoscopic fenestration was performed in all cases, and the cyst endothelium was destroyed . All operations were accomplished successfully. The mean operative time was 56 minutes (range 40-90 minutes). Intraoperative bleeding was 15 ml (range 5-30 ml), oral food intake was started on the first postoperative day. The median duration of postoperative hospitalization was 2.8 days (range 1-7 days). There were no postoperative complications. All cases were followed up for a period of 21 months to 5.5 years, and no recurrence occurred. Laparoscopic fenestration and endothelium obliteration is an advantageous approach to large non-parasitic splenic cysts with little postoperative pain, fast recovery, splenic tissue and splenism preservation, low complication rates, and a short hospital stay; it is easily accepted by patients. It yields favorable medium-term results. Our study confirms that good results can be achieved with an approach of laparoscopic fenestration and endothelium obliteration for simple non-parasitic splenic cysts.