Significance of splenic vein thrombosis in chronic pancreatitis

被引:86
作者
Agarwal, Anil K. [1 ]
Kumar, Raj
Agarwal, Shaleen
Singh, Shivendra
机构
[1] Gobind Ballabh Pant Hosp, Dept Gastrointestinal Surg, New Delhi 110002, India
关键词
gastric varices; portal hypertension; chronic pancreatitis; splenectomy; splenic vein; thrombosis;
D O I
10.1016/j.amjsurg.2007.07.039
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Splenic vein thrombosis leading to sinistral portal hypertension and variceal bleeding is a complication of chronic pancreatitis. The management of these patients without variceal bleeding remains controversial. METHODS: A total of 157 patients with chronic pancreatitis were managed consecutively in our center between January 1996 and December 2005. Thirty-four patients with chronic pancreatitis were diagnosed to have splenic vein thrombosis. RESULTS: The incidence of splenic vein thrombosis in patients with chronic pancreatitis was 22%. Fifteen percent of patients with chronic pancreatitis and splenic vein thrombosis presented with gastroesophageal variceal bleeding. Nine patients underwent splenectomy along with pancreatic procedures and 21 patients underwent pancreatic procedures only. Adding splenectomy to the pancreatic procedure did not lead to increased morbidity or mortality. CONCLUSION: Splenectomy should be added to the pancreatic procedure in patients who have evidence of portal hypertension on preoperative evaluation, especially if gastric varices are found. (c) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:149 / 154
页数:6
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