Concomitant splenic artery ligation has no preventive effect on left-sided portal hypertension following pancreaticoduodenectomy with the resection of the portal and superior mesenteric vein confluence for pancreatic ductal adenocarcinoma.
left‐sided portal hypertension
plenic artery ligation
splenic vein division
splenomegaly
thrombocytopenia
varices
Journal
Annals of gastroenterological surgery
ISSN: 2475-0328
Titre abrégé: Ann Gastroenterol Surg
Pays: Japan
ID NLM: 101718062
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
10
09
2021
revised:
30
11
2021
accepted:
27
12
2021
entrez:
31
5
2022
pubmed:
1
6
2022
medline:
1
6
2022
Statut:
epublish
Résumé
Left-sided portal hypertension (LSPH) caused by splenic vein (SV) division in pancreaticoduodenectomy (PD) with portal vein (PV) resection remains challenging. The current study aimed to investigate the efficacy of splenic artery (SA) ligation in preventing LSPH. One-hundred thirty patients who underwent PD with PV resection for pancreatic ductal adenocarcinoma were classified into SV and SA preservation (SVP, n = 30), SV resection and SA preservation (SVR, n = 59), and SV resection and SA ligation (SAL, n = 41). The postoperative incidence of LSPH was assessed. The incidence of variceal formation in SVP, SVR, and SAL were 4.8%, 53.2%, and 46.4% at 3 mo, 13.0%, 71.2%, and 62.5% at 6 mo, and 25.0%, 87.5%, and 87.1% at 12 mo, respectively. The rate was significantly higher in SVR at 3 and 6 mo ( In PD with PV resection, SAL delayed LSPH but could not prevent its occurrence.
Sections du résumé
Background
UNASSIGNED
Left-sided portal hypertension (LSPH) caused by splenic vein (SV) division in pancreaticoduodenectomy (PD) with portal vein (PV) resection remains challenging. The current study aimed to investigate the efficacy of splenic artery (SA) ligation in preventing LSPH.
Methods
UNASSIGNED
One-hundred thirty patients who underwent PD with PV resection for pancreatic ductal adenocarcinoma were classified into SV and SA preservation (SVP, n = 30), SV resection and SA preservation (SVR, n = 59), and SV resection and SA ligation (SAL, n = 41). The postoperative incidence of LSPH was assessed.
Results
UNASSIGNED
The incidence of variceal formation in SVP, SVR, and SAL were 4.8%, 53.2%, and 46.4% at 3 mo, 13.0%, 71.2%, and 62.5% at 6 mo, and 25.0%, 87.5%, and 87.1% at 12 mo, respectively. The rate was significantly higher in SVR at 3 and 6 mo (
Conclusion
UNASSIGNED
In PD with PV resection, SAL delayed LSPH but could not prevent its occurrence.
Identifiants
pubmed: 35634189
doi: 10.1002/ags3.12545
pii: AGS312545
pmc: PMC9130910
doi:
Types de publication
Journal Article
Langues
eng
Pagination
420-429Informations de copyright
© 2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology.
Références
J Gastrointest Surg. 2017 Mar;21(3):516-526
pubmed: 27921207
J Gastrointest Surg. 2011 Nov;15(11):2070-9
pubmed: 21913041
Transplantation. 2016 Oct;100(10):2138-45
pubmed: 27472097
Surgery. 2005 Jul;138(1):8-13
pubmed: 16003309
World J Surg. 2017 Aug;41(8):2111-2120
pubmed: 28258459
Pancreas. 2014 Apr;43(3):350-60
pubmed: 24622063
Langenbecks Arch Surg. 2021 Aug;406(5):1469-1479
pubmed: 33063227
Surgery. 2019 Feb;165(2):291-297
pubmed: 30268375
Arch Surg. 2011 Dec;146(12):1375-81
pubmed: 22184297
Transplantation. 2003 Apr 27;75(8):1313-7
pubmed: 12717222
Ann Surg. 2021 Jul 1;274(1):e36-e44
pubmed: 31356273
Int Surg. 1997 Apr-Jun;82(2):155-9
pubmed: 9331844
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Br J Surg. 2015 Feb;102(3):219-28
pubmed: 25524295
HPB (Oxford). 2017 Sep;19(9):785-792
pubmed: 28629642
Hepatogastroenterology. 2001 May-Jun;48(39):831-5
pubmed: 11462934
Dig Dis Sci. 2007 May;52(5):1141-9
pubmed: 17385040
J Gastrointest Surg. 2014 Jun;18(6):1209-15
pubmed: 24664421
Ann Surg. 2003 Mar;237(3):429-36
pubmed: 12616129
Langenbecks Arch Surg. 2021 Aug;406(5):1691-1695
pubmed: 33479791
Ann Gastroenterol Surg. 2022 Feb 10;6(3):420-429
pubmed: 35634189