From Splenectomy to Partial Splenic Embolization, Which is Better for Hereditary Spherocytosis?

Hereditary Spherocytosis (HS), with characteristic red blood cells (RBCs), is a group of genetic hemolytic disorders that occur in an autosomal-dominant manner. It is clinically characterized by anemia, splenomegaly, jaundice, and mutations in key genes. Splenectomy is the standard treatment for HS. Alternatively, partial splenic embolization (PSE) balances efficacy and safety, making it a promising solution. To determine how to choose surgery and ensure correct management, we reviewed the indications, techniques, efficacies, complications, and progress of alternative solutions to reach a comprehensive conclusion. Core clinical dimensions between Splenectomy and PSE in the treatment of HS, including surgical indications, operative techniques, hemoglobin improvement, infection risk, immune function preservation, long-term complications and recurrence rate. PSE is better than Splenectomy. Furthermore, forefront-targeted drugs, precise embolization ranges, and multidisciplinary team (MDT) discussions were reviewed. Collaboration requires multiple departments and family members. Through this narrative review, we hope to provide practical advice for long-term follow-up and emergency management.