title: [Prophylactic splenectomy for splenic vein thrombosis in patients undergoing resection for chronic pancreatitis].
abstract: OBJECTIVE
  Chronic pancreatitis (CP) is the leading cause of splenic vein thrombosis (SVT). SVT occurs in about 15 % of patients with CP. The risk of variceal bleeding in SVT is approximately 10 %. Splenectomy is indicated in symptomatic SVT but its role in asymptomatic SVT is discussed controversially. Aim of our study was to evaluate the outcome of splenectomy performed during pancreatic resection in patients with CP and asymptomatic SVT.
  
  
  METHODS
  33 of 198 patients undergoing resection for CP underwent concomitant prophylactic splenectomy for asymptomatic SVT. Perioperative data were compared in the groups of patients with or without splenectomy. Follow-up was complete in 84 % (average 31 months).
  
  
  RESULTS
  Median operative time, postoperative morbidity, reoperation rate and mortality were not different in patients with or without splenectomy. The median number of blood units transfused was higher in patients with prophylactic splenectomy (6 vs 4 units; p < 0.01). One complication of splenectomy (postoperative bleeding) occurred (3 %). During follow-up no variceal bleeding, no episode of postsplenectomy sepsis or thrombosis due to temporary thrombocytosis occurred.
  
  
  CONCLUSIONS
  Complications of prophylactic splenectomy are rare and less frequent than reported episodes of variceal bleeding. In the presence of asymptomatic SVT splenectomy should be considered during pancreatic resection to facilitate surgery and to avoid further variceal bleeding.
authors.affiliation: Chirurgische Universitätsklinik Freiburg. Makowiec@chir.ukl.uni-freiburg.de
authors.forename: F
authors.initials: F
authors.lastname: Makowiec
authors.forename: H
authors.initials: H
authors.lastname: Riediger
authors.forename: J
authors.initials: J
authors.lastname: Emmrich
authors.forename: J
authors.initials: J
authors.lastname: Kröger
authors.forename: U T
authors.initials: UT
authors.lastname: Hopt
authors.forename: U
authors.initials: U
authors.lastname: Adam
mesh_terms: D002908:Chronic Disease; D003952:Diagnostic Imaging; D005500:Follow-Up Studies; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010180:Pancreatectomy; D010195:Pancreatitis / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D012680:Sensitivity and Specificity; D013156:Splenectomy; D013162:Splenic Vein / Q000473:pathology / Q000601:surgery; D013927:Thrombosis / Q000175:diagnosis / Q000601:surgery*