{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:20:40Z","timestamp":1783354840224,"version":"3.54.6"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    : Laparoscopic splenectomy has become the preferred approach for most elective splenic indications; however, conversion to open surgery remains a relevant concern, particularly in complex cases. Long-term institutional experiences provide valuable insight into outcomes, learning curves, and evolving indications.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods<\/jats:bold>\n                    : A retrospective observational study was conducted at a tertiary referral center, including all consecutive patients who underwent laparoscopic splenectomy over a 20-year period. Demographic data, surgical indications, conversion to open surgery, and postoperative hospital stay were analyzed using descriptive statistics.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : A total of 125 patients underwent laparoscopic splenectomy during the study period. Hemato-logic diseases represented the predominant indication, while trauma, malignant conditions, infectious and parasitic diseases, and accessory spleen removal accounted for a smaller proportion of cases. Conversion to open surgery was required in 13 patients (10.4%). A temporal analysis demonstrated a reduction in conversion rates from the first decade to the second decade of the study, reflecting improved outcomes with increasing institutional experience. Postoperative recovery was generally favorable, with a short postoperative length of hospital stay.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : Laparoscopic splenectomy is a safe and effective procedure for a broad range of splenic pathologies, most commonly hematologic disorders. Over a 20-year experience, acceptable conversion rates and favorable postoperative outcomes were achieved, with evidence of improvement over time. Careful patient selection, standardized surgical technique, and accumulated surgical experience remain key determinants of optimal outcomes.\n                  <\/jats:p>","DOI":"10.2478\/prilozi-2026-0013","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:10:33Z","timestamp":1783350633000},"page":"5-12","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Splenectomy: Outcomes and Conversion Trends from A 20-Year Single-Center Experience"],"prefix":"10.2478","volume":"47","author":[{"given":"Rexhep","family":"Selmani","sequence":"first","affiliation":[{"name":"University Clinic of Digestive Surgery , Faculty of Medicine , Skopje , RN Macedonia"},{"name":"Faculty of Medicine , Ss. Cyril and Methodius University , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qemal","family":"Rushiti","sequence":"additional","affiliation":[{"name":"University Clinic of Digestive Surgery , Faculty of Medicine , Skopje , RN Macedonia"},{"name":"Faculty of Medicine , Ss. Cyril and Methodius University , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaban","family":"Memeti","sequence":"additional","affiliation":[{"name":"University Clinic of Pediatric Surgery , Faculty of Medicine , Skopje , RN Macedonia"},{"name":"Faculty of Medicine , Ss. Cyril and Methodius University , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Sulejmani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine , Ss. Cyril and Methodius University , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"2026070616020251174_j_prilozi-2026-0013_ref_001","doi-asserted-by":"crossref","unstructured":"Abo Shloaa M, El Moaled G, Saad M, Foaad M, El Maleh H. Predictors for conversion in laparoscopic splenectomy: a prospective randomized study. Ain Shams J Surg. 2011;8(1):19\u201328.","DOI":"10.21608\/asjs.2011.179138"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_002","doi-asserted-by":"crossref","unstructured":"Almahadi MSA, Hussain RA, Alotaibi RM, Alruwaili AN, Alasmari ASG, Alshahrani MSA, et al. Efficacy and complications of open versus laparoscopic splenectomy: a systematic review. 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Laparoscopic splenectomy: outcome and efficacy in 103 consecutive patients. Ann Surg. 1998;228(4):568\u2013578.","DOI":"10.1097\/00000658-199810000-00013"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_006","doi-asserted-by":"crossref","unstructured":"Memeti S, Kuci S, Ristevski T, Todorovic L, Kamilovski M, Krsteska B, et al. Clinical management and surgical outcomes of wandering spleen with splenic torsion in pediatric patients: a case report. Albanian J Trauma Emerg Surg. 2025;9(1):1702\u20131706.","DOI":"10.32391\/ajtes.v9i1.441"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_007","doi-asserted-by":"crossref","unstructured":"Meng M, Choi PJK, Pydi R, Farkas DT. Evaluating the effectiveness of laparoscopic removal of an accessory spleen after a failed splenectomy for immune thrombocytopenia. Cureus. 2024;16(7):e277719.","DOI":"10.7759\/cureus.65876"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_008","doi-asserted-by":"crossref","unstructured":"Misiakos EP, Bagias G, Liakakos T, Machairas A. Laparoscopic splenectomy: current concepts. World J Gastrointest Endosc. 2017;9(9):428\u2013437.","DOI":"10.4253\/wjge.v9.i9.428"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_009","unstructured":"Chalkoo MC, Habib M, Raina AH, Hamid F, Malla SN, Malik IA. Indications, surgical technique and outcomes of laparoscopic splenectomy: a retrospective descriptive study from Srinagar, India. J Clin Diagn Res. 2025;19(1):PC14\u2013PC17."},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_010","doi-asserted-by":"crossref","unstructured":"Remiker A, Neunert C. Splenectomy for immune thrombocytopenia: the evolution and preservation of treatment. 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G Chir. 2015;36(3):101\u2013105.","DOI":"10.11138\/gchir\/2015.36.3.101"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_020","doi-asserted-by":"crossref","unstructured":"Pattenden CJ, Mann CD, Metcalfe MS, Garcea G, Dennison AR, Berry DP. Laparoscopic splenectomy: a single-centre experience of 140 cases. Ann R Coll Surg Engl. 2010;92(6):492\u2013496.","DOI":"10.1308\/003588410X12664192076133"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_021","doi-asserted-by":"crossref","unstructured":"Fu Y, Chen Q, Hu Z, Wang Y, Zhou Z, Zhu J, et al. Short- and long-term outcomes of 486 consecutive laparoscopic splenectomies: a single-center experience. Medicine (Baltimore). 2021;100(14):e25456.","DOI":"10.1097\/MD.0000000000025308"},{"key":"2026070616020251174_j_prilozi-2026-0013_ref_022","doi-asserted-by":"crossref","unstructured":"Aly AM, Abd El Maksoud WM, Hassan MM, El-Kased AF. Laparoscopic splenectomy: experience of a tertiary center in a developing country. 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