Gastric bleeding risk following spleen preserving distal pancreatectomy with excision of the splenic vessels: a long-term follow-up.
HPB (Oxford)
; 19(4): 345-351, 2017 04.
Article
in En
| MEDLINE
| ID: mdl-28089365
ABSTRACT
BACKGROUND:
Spleen-preserving distal pancreatectomy with resection of the splenic vessels (VR-SPDP) is an effective procedure. However, hemodynamic changes in splenogastric circulation may lead to the development of gastric varices (GV) with a risk of gastrointestinal (GI) bleeding. This retrospective study aimed to assess the long-term postoperative clinical follow-up of patients and review the late postoperative abdominal computed tomography (CT) or endoscopic examination.METHODS:
From 1988 to 2015, 48 consecutive VR-SPDP for benign or low-grade malignant disease were included. Late postoperative follow-up was undertaken with the use of a prospective database and assessment undertaken by CT and/or endoscopy.RESULTS:
The median follow-up was 76 months (range 12-334 months). Two patients were lost to follow-up. Gastrointestinal hemorrhage occurred in one patient. Endoscopy and abdominal CT showed submucosal GV in five patients. Ten patients had perigastric varices (27%), but none developed clinical complications from their varices. All varices occurred within one year after distal pancreatectomy and remained stable during follow-up.DISCUSSION:
Asymptomatic varices frequently occurred in patients who underwent VR-SPDP, but bleeding risk seemed low. Abdominal CT could identify GV and distinguish submucosal varices with a higher risk of gastric bleeding.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatectomy
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Splenic Artery
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Splenic Vein
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Stomach Diseases
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Esophageal and Gastric Varices
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Organ Sparing Treatments
/
Gastrointestinal Hemorrhage
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
HPB (Oxford)
Journal subject:
GASTROENTEROLOGIA
Year:
2017
Type:
Article
Affiliation country:
France