Gastric bleeding risk following spleen preserving distal pancreatectomy with excision of the splenic vessels: a long-term follow-up
| Autor: | Laurent Ghouti, Sylvain Kirzin, D. Louis, M. Chalret du Rieu, S. Blaye-Felice, Eric Bloom, Nicolas Carrere, Guillaume Portier, C.H. Julio, A. Alassiri, B. Pradère |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Databases Factual Stomach Diseases Hemodynamics 030230 surgery Esophageal and Gastric Varices Risk Assessment Asymptomatic Young Adult 03 medical and health sciences Pancreatectomy 0302 clinical medicine Risk Factors Gastroscopy medicine Humans Young adult Aged Retrospective Studies Hepatology medicine.diagnostic_test business.industry Gastroenterology Retrospective cohort study Perigastric Middle Aged Gastric varices medicine.disease Surgery Endoscopy Treatment Outcome Splenic Vein 030220 oncology & carcinogenesis Female Radiology medicine.symptom Gastrointestinal Hemorrhage Tomography X-Ray Computed Varices business Organ Sparing Treatments Splenic Artery Follow-Up Studies |
| Zdroj: | HPB. 19:345-351 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2016.12.003 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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