[Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy].
Here, we report a case of Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy. A 69-year old man underwent pancreatoduodenectomy for pancreatic cancer in 2006 in which the splenic vein was ligated near the portal vein and then divided. The patient suffered repeated episodes of anemia between 2010 and 2013. However, we could not identify the bleeding site at that time. In 2011, local recurrence was detected. Disease progression occurred despite chemotherapy treatment, which was then discontinued. The left-sided portal hypertension gradually progressed, and the collateral vessels became dilated. In 2014, he was examined in our department for gastrointestinal bleeding. An upper gastrointestinal endoscopy revealed bleeding from gastric varices. Gastrointestinal bleeding ceased after endoscopic injection sclerotherapy ( EIS) was performed; however, the bleeding recurred. Balloon retrograde transvenous occlusion (BRTO) could not be performed because blood flow was not detected within the gastro-renal shunt. An emergency surgery was performed. Surgical splenectomy and devascularization (Hassab's operation) were performed. After surgery, the gastric body varices and gastrointestinal anastomosis disappeared and the bleeding did not occur. He is currently receiving outpatient treatment.
Dept. of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medical Sciences.
Tadahiro
T
Goto
Ippei
I
Matsumoto
Makoto
M
Shinzeki
Hirochika
H
Toyama
Sadaki
S
Asari
Azusa
A
Ueta
Jun
J
Ishida
Yoshihide
Y
Nanno
Shinichi
S
So
Hisoka
H
Kinoshita
Taku
T
Matsumoto
Kaori
K
Kuramitsu
Motofumi
M
Tanaka
Atsushi
A
Takebe
Masahiro
M
Kido
Tetsuo
T
Ajiki
Takumi
T
Fukumoto
Yonson
Y
Ku
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000601:surgery; D008297:Male; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome
D000970:Antineoplastic Agents