Experience of endoscopic treatment of patients with large splenic cysts using the transgastric point and de-epithelialization method under endosonography control

Introduction. Splenic cysts are rare benign neoplasms, occurring with an incidence of approximately 0.75 per 100,000 population per year. These neoplasms are significantly less common than cystic lesions of other organs, such as the liver, pancreas, and kidneys, and account for less than 1% of all cystic lesions of internal organs. In most cases, splenic cysts are asymptomatic and are discovered incidentally during instrumental examinations. For a long time, surgical treatment of patients with splenic cysts involved open or laparoscopic spleen resection, as well as splenectomy. However, in recent years, minimally invasive treatment approaches have become increasingly used in clinical practice, particularly ultrasound-guided cyst drainage followed by sclerotherapy and de-epithelialization of the cyst walls. Clinical observation. A 20-year-old female patient underwent surgical treatment in the Surgical Endoscopic Department of the A.V. Vishnevsky National Medical Research Center of Surgery for a nonparasitic cyst located in the hilum of the spleen, measuring over 6 cm. Results. In our clinical observation of a patient with a large splenic cyst, we successfully performed a minimally invasive procedure involving endoluminal transgastric puncture and endosonographically guided splenic cyst de-epithelialization. Conclusion. Endoscopic endoluminal transgastric puncture followed by endosonographically guided splenic cyst de-epithelialization represents an optimal minimally invasive technique and a preferred alternative to traditional surgical interventions.