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Risk of Varices Bleeding after Spleen-Preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Spleen-preserving distal pancreatectomy with excision of splenic vessels (SPDP-ESV) has been widely adopted because of its simplicity. However, this simplified technique may lead to gastric varices and bleeding.

Methods

For better understanding of the hemodynamic changes and risk of gastric variceal bleeding, we instituted a prospective study to perform serial follow-up contrast abdominal computed tomography (CT) and endoscopy for patients after SPDP-ESV.

Results

There were 37 patients, with a mean follow-up period of 45.3 months (range 23–59 months), included in the analysis. Of the 37 patients studied, 11 (29.7%) had perigastric varices, 12 (32.4%) had splenomegaly, and 3 (8.1%) had gastric submucosal varices on follow-up CT performed 6 months after surgery. Endoscopy also showed gastric varices in three patients with gastric submucosal varices on CT scan. CT performed 18 months after surgery showed no progression of splenomegaly or gastric submucosal varices. Follow-up endoscopies also showed three gastric varices detected on endoscopy at 6 months to be stationary.

Conclusions

Based on serial CT and endoscopic examinations, the first postoperative months will show who is at risk of gastric variceal bleeding.

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Authors and Affiliations

  1. Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC

    Yu-Wen Tien MD, PhD, Rey-Heng Hu MD, PhD, King-Jen Chang MD, PhD & Po-Huang Lee MD, PhD

  2. Department of Radiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC

    Kao-Lang Liu MD

  3. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC

    Hsiu-Po Wang MD

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  1. Yu-Wen Tien MD, PhD
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  2. Kao-Lang Liu MD
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  3. Rey-Heng Hu MD, PhD
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  4. Hsiu-Po Wang MD
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  5. King-Jen Chang MD, PhD
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  6. Po-Huang Lee MD, PhD
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Correspondence to Yu-Wen Tien MD, PhD.

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Tien, YW., Liu, KL., Hu, RH. et al. Risk of Varices Bleeding after Spleen-Preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein. Ann Surg Oncol 17, 2193–2198 (2010). https://doi.org/10.1245/s10434-010-0983-6

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  • DOI: https://doi.org/10.1245/s10434-010-0983-6

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