Laparoscopic splenectomy for splenic abscess.

Splenic abscess is a rare clinical entity, and splenectomy remains the treatment of choice. We sought to determine the safety and efficacy of laparoscopic splenectomy in this setting. Using a prospective database of laparoscopic splenectomy, we identified 4 patients who underwent surgery for splenic abscess (3 male, 1 female). Mean age was 55.5 (range 42-78) years. Patient symptoms included: fever and abdominal pain in 4 patients, pleural effusions in 2, and nausea and leukocytosis in 1. Risk factors for splenic abscess included septic emboli from bacterial endocarditis in 2 patients and acquired immune deficiency syndrome in 1. All patients underwent successful laparoscopic splenectomy. Mean operative time was 200 (range 160-220) minutes, and blood loss was 220 (range 100-450) mL. There were no postoperative complications or deaths; postoperative length of stay averaged 14 (range 2-26) days. Despite the difficulty of the operation, the laparoscopic approach appears to be a safe and effective treatment of splenic abscess.