An open label randomized control trial to compare the outcomes with and without preoperative splenic artery embolization SAE in patients with moderate splenomegaly undergoing elective laparoscopic splenectomy undergoing elective laparoscopic splenectomy

There is meagre evidence comparing the effect of pre operative splenic artery embolisation (SAE) with laparoscopic splenectomy (LS) alone in patients with splenomegaly. While no indication exists in mild splenomegaly, various studies have demonstrated a positive result of pre operative SAE before elective LS in patients with moderate and massive splenomegaly. This includes lesser intra operative blood loss, lesser transfusion rates and reduction in splenic size, facilitating better handling of spleen during surgery. However, the current evidence mainly comprises of observational studies with a small sample size and no experimental studies are available.

The current SAGES guidelines suggest that pre operative SAE before laparoscopic splenectomy in patients with splenomegaly should be the surgeon and patient’s shared decision and is based on low certainty evidence. Thus, this randomized control trial aims to establish the certainty and feasibility of pre operative SAE before laparoscopic splenectomy in cases of moderate splenomegaly.