Splenic Injury in Sleeve Gastrectomy: Mechanisms, Risk Factors, and Management Strategies

Abstract

Splenic injury represents a rare but significant complication during laparoscopic sleeve gastrectomy that can lead to considerable morbidity if not promptly diagnosed and managed. This comprehensive review aims to elucidate the mechanisms underlying splenic injuries, assess patient- and procedure-specific risk factors, and evaluate the clinical presentation and management strategies for these events. A literature search was performed across major databases to identify relevant articles published over the past decades. Evidence suggests that factors such as technical nuances during dissection, the handling of short gastric vessels, and patient-specific anatomical variations contribute to the risk of splenic injury. Management ranges from conservative monitoring to surgical interventions, such as splenectomy or embolization, depending on the severity of the injury. Furthermore, this review discusses preventive measures and techniques to minimize these risks, offering important insights for bariatric surgeons to enhance patient outcomes.