Treatment results of splenectomy and cholecystectomy for hemolytic diseases

Aim: To evaluate the results of splenectomy and cholecystectomy in patients with hemolytic disease. Material and method: Patients who underwent splenectomy between 2003 and 2023 were retrospectively analyzed. Age, gender, primary diagnosis, splenomegaly, presence of accessory spleen, surgical technique, presence of cholelithiasis and cholecystectomy, laboratory findings and complications were evaluated. Results: In 87 of 197 splenectomy cases, the indication was hemolytic disease. These included 61 cases of hereditary spherocytosis (HS), 10 cases of thalassemia and 9 cases of immune thrombocytopenia (ITP). In 7 cases, more rare hemolytic pathologies were seen. 72 cases were performed by open technique and 15 cases were performed laparoscopically. 55 of 87 patients underwent simultaneous cholecystectomy, and 1 patient underwent complementary cholecystectomy at a later period. While the presence of cholelithiasis was known in 45 of these 55 patients, cholecystectomy was performed prophylactically in the remaining 10 patients. Accessory spleen was detected and removed in a total of 25 patients. In all disease groups, hemoglobin and platelet values increased significantly in postoperative first year. During follow-up, no post-splenectomy sepsis was observed in any patient. One patient with hemophagocytic disease who had perforation in the ileum and caecum 1.5 years after splenectomy died. Conclusion: Splenectomy is a safe surgical option with low complication rate in hemolytic diseases to reduce hemolysis findings and transfusion requirement. Simultaneous cholecystectomy can also be performed in the presence of cholelithiasis or prophylactically. Key words: Hemolytic disease, splenectomy, cholecystectomy.