Significance of splenic vein thrombosis in chronic pancreatitis
Significance of splenic vein thrombosis in chronic pancreatitis
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DOI：
10.1016/j.amjsurg.2007.07.039
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发表时间：
2008-08-01
影响因子：
3
通讯作者：
Singh, Shivendra
中科院分区：
文献类型：
--
作者：
Agarwal, Anil K.;Kumar, Raj;Singh, Shivendra
背景：脾静脉血栓形成导致左门静脉高压和静脉曲张出血是慢性胰腺炎的并发症。这些患者没有静脉曲张出血的管理仍然存在争议。方法：1996年1月至2005年12月，共有157例慢性胰腺炎患者在我们的中心连续管理。结果：慢性胰腺炎患者脾静脉血栓形成的发生率为22%。15%的慢性胰腺炎和脾静脉血栓形成患者表现为胃食管静脉曲张出血。9例患者接受脾切除术沿着胰腺手术，21例患者仅接受胰腺手术。在胰腺手术中增加脾切除术并没有导致发病率或死亡率增加。结论：脾切除术应添加到胰腺手术中的患者有门静脉高压症的证据，术前评估，特别是如果发现胃静脉曲张。（c）2008年爱思唯尔公司。All rights reserved.
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.