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Background <p>Splenic cysts are rare in children, and recurrence after spleen-preserving laparoscopic excision remains poorly quantified. This study evaluates outcomes of laparoscopic surgery for pediatric splenic cysts with focus on recurrence and conversion predictors.</p> Methods <p>This retrospective cohort study analyzed 18 consecutive pediatric patients (age &lt; 18 years) who underwent laparoscopic-first surgical management for splenic cysts at a tertiary center between January 2018 and December 2024. All patients were attempted laparoscopically with predefined conversion criteria. Data were collected retrospectively from medical records. Primary outcome was recurrence after cyst excision. Secondary outcomes included conversion predictors, operative parameters, complications, and length of stay.</p> Results <p>Fifteen procedures (83.3%) were completed laparoscopically; 3 (16.7%) required conversion due to dense adhesions (<i>n</i> = 2) or massive size (<i>n</i> = 1). Median cyst size was significantly larger in converted cases (12.5&#xa0;cm vs. 5.8&#xa0;cm, <i>p</i> = 0.008). Among 10 patients undergoing cyst excision with splenic preservation, 3 (30%) developed recurrence versus 0 recurrence among 8 splenectomy patients. All recurrences were asymptomatic and managed expectantly. Completed laparoscopic procedures had significantly lower blood loss (35 mL vs. 280 mL, <i>p</i> &lt; 0.001) and shorter hospital stay (2 days vs. 5 days, <i>p</i> = 0.012) compared with conversions.</p> Conclusions <p>Laparoscopic approach for pediatric splenic cysts is feasible with 16.7% conversion rate. Cyst size exceeding 10&#xa0;cm predicts conversion. Recurrence after spleen-preserving excision (30%) necessitates long-term surveillance, though all recurrences remained asymptomatic without requiring reintervention.</p>

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Laparoscopic management of large pediatric splenic cysts: seven-year experience and recurrence risk assessment after spleen-preserving surgery

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Ahmed Abdelmohsen,
  • Mahmoud Moussa,
  • Mohamed Hussein,
  • Refaat Badawy,
  • Mohamed El-Soudani,
  • Mohamed Emara,
  • Shady Sharaf

摘要

Background

Splenic cysts are rare in children, and recurrence after spleen-preserving laparoscopic excision remains poorly quantified. This study evaluates outcomes of laparoscopic surgery for pediatric splenic cysts with focus on recurrence and conversion predictors.

Methods

This retrospective cohort study analyzed 18 consecutive pediatric patients (age < 18 years) who underwent laparoscopic-first surgical management for splenic cysts at a tertiary center between January 2018 and December 2024. All patients were attempted laparoscopically with predefined conversion criteria. Data were collected retrospectively from medical records. Primary outcome was recurrence after cyst excision. Secondary outcomes included conversion predictors, operative parameters, complications, and length of stay.

Results

Fifteen procedures (83.3%) were completed laparoscopically; 3 (16.7%) required conversion due to dense adhesions (n = 2) or massive size (n = 1). Median cyst size was significantly larger in converted cases (12.5 cm vs. 5.8 cm, p = 0.008). Among 10 patients undergoing cyst excision with splenic preservation, 3 (30%) developed recurrence versus 0 recurrence among 8 splenectomy patients. All recurrences were asymptomatic and managed expectantly. Completed laparoscopic procedures had significantly lower blood loss (35 mL vs. 280 mL, p < 0.001) and shorter hospital stay (2 days vs. 5 days, p = 0.012) compared with conversions.

Conclusions

Laparoscopic approach for pediatric splenic cysts is feasible with 16.7% conversion rate. Cyst size exceeding 10 cm predicts conversion. Recurrence after spleen-preserving excision (30%) necessitates long-term surveillance, though all recurrences remained asymptomatic without requiring reintervention.