Annals of Surgical Oncology

, Volume 17, Issue 8, pp 2193–2198

Risk of Varices Bleeding after Spleen-Preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein

  • Yu-Wen Tien
  • Kao-Lang Liu
  • Rey-Heng Hu
  • Hsiu-Po Wang
  • King-Jen Chang
  • Po-Huang Lee
Thoracic Oncology

DOI: 10.1245/s10434-010-0983-6

Cite this article as:
Tien, YW., Liu, KL., Hu, RH. et al. Ann Surg Oncol (2010) 17: 2193. doi:10.1245/s10434-010-0983-6

Abstract

Background

Spleen-preserving distal pancreatectomy with excision of splenic vessels (SPDP-ESV) has been widely adopted because of its simplicity. However, this simplified technique may lead to gastric varices and bleeding.

Methods

For better understanding of the hemodynamic changes and risk of gastric variceal bleeding, we instituted a prospective study to perform serial follow-up contrast abdominal computed tomography (CT) and endoscopy for patients after SPDP-ESV.

Results

There were 37 patients, with a mean follow-up period of 45.3 months (range 23–59 months), included in the analysis. Of the 37 patients studied, 11 (29.7%) had perigastric varices, 12 (32.4%) had splenomegaly, and 3 (8.1%) had gastric submucosal varices on follow-up CT performed 6 months after surgery. Endoscopy also showed gastric varices in three patients with gastric submucosal varices on CT scan. CT performed 18 months after surgery showed no progression of splenomegaly or gastric submucosal varices. Follow-up endoscopies also showed three gastric varices detected on endoscopy at 6 months to be stationary.

Conclusions

Based on serial CT and endoscopic examinations, the first postoperative months will show who is at risk of gastric variceal bleeding.

Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Yu-Wen Tien
    • 1
  • Kao-Lang Liu
    • 2
  • Rey-Heng Hu
    • 1
  • Hsiu-Po Wang
    • 3
  • King-Jen Chang
    • 1
  • Po-Huang Lee
    • 1
  1. 1.Department of SurgeryNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan, ROC
  2. 2.Department of RadiologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan, ROC
  3. 3.Department of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan, ROC