TY - JOUR
T1 - Hemodynamic changes of splenogastric circulation after spleen-preserving pancreatectomy with excision of splenic artery and vein
AU - Miura, Fumihiko
AU - Takada, Tadahiro
AU - Asano, Takehide
AU - Kenmochi, Takashi
AU - Ochiai, Takenori
AU - Amano, Hodaka
AU - Yoshida, Masahiro
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2005/9
Y1 - 2005/9
N2 - Background. The safety of spleen conservation without preservation of the splenic artery and vein was proved on the basis of short-term observation, but the long-term results of this procedure have been uncertain. To clarify the hemodynamic changes of splenogastric circulation of patients undergoing spleen-preserving pancreatectomy with excision of the splenic artery and vein, we retrospectively analyzed patient outcome with particular reference to the assessment of hemodynamic changes of splenogastric circulation. Methods. Ten patients who had undergone spleen-preserving pancreatectomy with excision of the splenic artery and vein were retrospectively analyzed. In all patients both the short gastric and left gastroepiploic arteries and veins were preserved. All patients were observed for a minimum of 52 months. Collateral venous pathways were evaluated by computed tomography and endoscopy. Results. Early complications such as splenic infarction and atrophy did not occur in any of the patients, but computed tomography revealed perigastric varices in 7 patients (70%) and submucosal varices in 2 patients (20%). Endoscopy showed gastric varices in 2 patients in whom submucosal gastric varices were identified on computed tomography. Gastrointestinal bleeding from gastric varices occurred in 1 patient. In 1 patient without gastric varices, a gastrorenal shunt was demonstrated on computed tomography. Conclusions. This study confirmed that gastric varices frequently occurred in patients who underwent spleen-preserving pancreatectomy with excision of the splenic artery and vein.
AB - Background. The safety of spleen conservation without preservation of the splenic artery and vein was proved on the basis of short-term observation, but the long-term results of this procedure have been uncertain. To clarify the hemodynamic changes of splenogastric circulation of patients undergoing spleen-preserving pancreatectomy with excision of the splenic artery and vein, we retrospectively analyzed patient outcome with particular reference to the assessment of hemodynamic changes of splenogastric circulation. Methods. Ten patients who had undergone spleen-preserving pancreatectomy with excision of the splenic artery and vein were retrospectively analyzed. In all patients both the short gastric and left gastroepiploic arteries and veins were preserved. All patients were observed for a minimum of 52 months. Collateral venous pathways were evaluated by computed tomography and endoscopy. Results. Early complications such as splenic infarction and atrophy did not occur in any of the patients, but computed tomography revealed perigastric varices in 7 patients (70%) and submucosal varices in 2 patients (20%). Endoscopy showed gastric varices in 2 patients in whom submucosal gastric varices were identified on computed tomography. Gastrointestinal bleeding from gastric varices occurred in 1 patient. In 1 patient without gastric varices, a gastrorenal shunt was demonstrated on computed tomography. Conclusions. This study confirmed that gastric varices frequently occurred in patients who underwent spleen-preserving pancreatectomy with excision of the splenic artery and vein.
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U2 - 10.1016/j.surg.2005.04.020
DO - 10.1016/j.surg.2005.04.020
M3 - Article
C2 - 16213907
AN - SCOPUS:26244446560
VL - 138
SP - 518
EP - 522
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 3
ER -