Effect of spleen size on complications of laparoscopic sleeve gastrectomy

Abstract

Introduction: In bariatric surgery, examining the spleen dimensions via USG in a routine manner prior to surgery, could help the physician to predict probable complications on bariatric surgery as enlarged spleen size restricts the surgeon’s working area and leaks often occur in the upper part of the stomach adjacent to the spleen. The aim of this research was to elucidate the benefits of spleen USG in pre-operative period to determine the risk of complications in advance. Materials and Methods: A total of 316 patients who had undergone sleeve gastrectomy have been retrospectively analyzed. The spleen dimensions of the patients were obtained from the routine USG reports and CT scans. In this research we took the spleen size as 12 cm from the previous radiological studies in the literature and stated the ones above this reference point. Results: The number of staples and duration of surgery were higher in individuals with abnormal spleen size compared to individuals with normal spleen dimensions. Presence of CAD – arrhythmia and asthma – COPD were effective in the development of complications (p<0.05) according to logistic regression analysis. Considering the factors affecting the development of complications, CAD-Arrhythmia caused a 5-fold increase, and asthma-COPD 4.9-fold increased the development of complications. Conclusion: In patients scheduled for bariatric surgery, examining spleen dimensions via USG imaging in a routine manner prior to surgery, could help the physician to predict probable complications on bariatric surgery due to spleen size.