title: Multi-visceral resection of malignant tumors with left-sided portal hypertension.
abstract: OBJECTIVE
  Left-sided portal hypertension (LSPH) is an uncommon clinical syndrome which may lead to bleeding from isolated gastric varices and pancreatitis is the most common etiology. Despite the particular rare incidence of LPSH caused by malignant tumor, the optimal management remains undefined.
  
  
  METHODS
  From January 2006 to December 2009, a total of 8 patients of left-sided portal hypertension caused by malignancies were admitted into the department of surgery of our hospital. Medical records of those patients were retrieved and analyzed, including etiologies, clinical presentations, diagnostic methods and surgical approaches.
  
  
  RESULTS
  Of current series, pancreatic tumors (5/8) and retroperitoneal tumors (3/8) were the primary etiologies. Those patients mainly presented with upper gastrointestinal bleeding or irregular left upper abdominal pain and isolated gastric varices became important clinical evidence. All those patients were performed multi-visceral resection. No recurrent upper gastrointestinal bleeding occurred during the follow-up period and three patients died 6, 18 and 21 months postoperatively.
  
  
  CONCLUSIONS
  Although LSPH caused by malignant tumor is uncommon and difficult to deal with, deliberate evaluation of preoperative CT images will ensure the success of an aggressive multi-visceral resection and the prognoses in those patients are relatively promising.
authors.affiliation: Department of Surgery, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Jia-Zeng
authors.initials: JZ
authors.lastname: Ding
authors.forename: Ji-Qi
authors.initials: JQ
authors.lastname: Yan
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Yang
authors.forename: Di
authors.initials: D
authors.lastname: Ma
authors.forename: Zong-Yuan
authors.initials: ZY
authors.lastname: Tao
authors.forename: Cheng-Hong
authors.initials: CH
authors.lastname: Peng
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications*; D012186:Retroperitoneal Neoplasms / Q000150:complications*; D014057:Tomography, X-Ray Computed