Hemodynamic changes of splenogastric circulation after spleen-preserving pancreatectomy with excision of splenic artery and vein.
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.
Miura
Fumihiko
F
Department of Surgery, Teikyo University, School of Medicine, Tokyo, Japan.
Takada
Tadahiro
T
Asano
Takehide
T
Kenmochi
Takashi
T
Ochiai
Takenori
T
Amano
Hodaka
H
Yoshida
Masahiro
M
D004932:Esophageal and Gastric Varices / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D010180:Pancreatectomy / Q000379:methods*; D012189:Retrospective Studies; D013154:Spleen; D013157:Splenic Artery; D013270:Stomach / Q000098:blood supply*; D016896:Treatment Outcome