DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.045

Pages: 2850-2853

Laparoscopic partial splenectomy (LPS) is the preferred spleen-preserving approach for benign lesions, avoiding the risks of total splenectomy. However, the technique remains technically demanding, particularly for large cysts extending to the splenic hilum. We present a case highlighting the technical nuances of selective vascular control and the management of a significant, delayed complication. A 22-year-old female presented with chronic left upper quadrant pain. CT imaging revealed a 50x70 mm epidermoid cyst at the lower pole, extending to the splenic hilum. She underwent an LPS. This case demonstrates that selective vascular ligation is a feasible technique for hilar lesions. However, it also serves as a crucial reminder that significant complications can occur in a delayed fashion, well after the initial discharge. LPS for large epidermoid cysts extending to the hilum is technically feasible. Key lessons include: [1] meticulous hilar dissection with selective vessel ligation provides excellent vascular control, [2] this approach maximizes parenchymal preservation, and [3] clinicians must maintain a high index of suspicion for delayed complications, such as symptomatic pleural effusion, which may require intervention