Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention

To achieve curative resection for pancreatic cancer during pancreaticoduodenectomy (PD), extensive portal vein (PV) resection, including porto-mesenterico-splenic confluence (PMSC), may sometimes be necessary if the tumor is close to the portal venous system. Recently, this extended resection has be...

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Autores principales:	Yoshihiro Ono, Yosuke Inoue, Tomotaka Kato, Kiyoshi Matsueda, Atsushi Oba, Takafumi Sato, Hiromichi Ito, Akio Saiura, Yu Takahashi
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	sinistral portal hypertension pancreatic cancer pancreaticoduodenectomy splenic vein ligation/resection gastrointestinal varices gastrointestinal bleeding Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/5c3f2c676b8c47bfa0e866c963c9e049
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spelling	oai:doaj.org-article:5c3f2c676b8c47bfa0e866c963c9e0492021-11-11T15:28:35ZSinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention10.3390/cancers132153342072-6694https://doaj.org/article/5c3f2c676b8c47bfa0e866c963c9e0492021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5334https://doaj.org/toc/2072-6694To achieve curative resection for pancreatic cancer during pancreaticoduodenectomy (PD), extensive portal vein (PV) resection, including porto-mesenterico-splenic confluence (PMSC), may sometimes be necessary if the tumor is close to the portal venous system. Recently, this extended resection has been widely accepted in high-volume centers for pancreatic resection due to its favorable outcomes compared with non-operative treatment. However, in patients with long-term survival, sinistral portal hypertension (SPH) occurs as a late-onset postoperative complication. These patients present gastrointestinal varices due to congested venous flow from the spleen, which may cause critical variceal bleeding. Since the prognosis of patients with pancreatic cancer has improved, owing to the development of chemotherapy and surgical techniques, SPH is no longer a negligible matter in the field of pancreatic cancer surgery. This review clarifies the pathogenesis and frequency of SPH after PD through PMSC resection and discusses its prediction and prevention.Yoshihiro OnoYosuke InoueTomotaka KatoKiyoshi MatsuedaAtsushi ObaTakafumi SatoHiromichi ItoAkio SaiuraYu TakahashiMDPI AGarticlesinistral portal hypertensionpancreatic cancerpancreaticoduodenectomysplenic vein ligation/resectiongastrointestinal varicesgastrointestinal bleedingNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5334, p 5334 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sinistral portal hypertension pancreatic cancer pancreaticoduodenectomy splenic vein ligation/resection gastrointestinal varices gastrointestinal bleeding Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	sinistral portal hypertension pancreatic cancer pancreaticoduodenectomy splenic vein ligation/resection gastrointestinal varices gastrointestinal bleeding Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yoshihiro Ono Yosuke Inoue Tomotaka Kato Kiyoshi Matsueda Atsushi Oba Takafumi Sato Hiromichi Ito Akio Saiura Yu Takahashi Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention
description	To achieve curative resection for pancreatic cancer during pancreaticoduodenectomy (PD), extensive portal vein (PV) resection, including porto-mesenterico-splenic confluence (PMSC), may sometimes be necessary if the tumor is close to the portal venous system. Recently, this extended resection has been widely accepted in high-volume centers for pancreatic resection due to its favorable outcomes compared with non-operative treatment. However, in patients with long-term survival, sinistral portal hypertension (SPH) occurs as a late-onset postoperative complication. These patients present gastrointestinal varices due to congested venous flow from the spleen, which may cause critical variceal bleeding. Since the prognosis of patients with pancreatic cancer has improved, owing to the development of chemotherapy and surgical techniques, SPH is no longer a negligible matter in the field of pancreatic cancer surgery. This review clarifies the pathogenesis and frequency of SPH after PD through PMSC resection and discusses its prediction and prevention.
format	article
author	Yoshihiro Ono Yosuke Inoue Tomotaka Kato Kiyoshi Matsueda Atsushi Oba Takafumi Sato Hiromichi Ito Akio Saiura Yu Takahashi
author_facet	Yoshihiro Ono Yosuke Inoue Tomotaka Kato Kiyoshi Matsueda Atsushi Oba Takafumi Sato Hiromichi Ito Akio Saiura Yu Takahashi
author_sort	Yoshihiro Ono
title	Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention
title_short	Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention
title_full	Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention
title_fullStr	Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention
title_full_unstemmed	Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention
title_sort	sinistral portal hypertension after pancreaticoduodenectomy with splenic vein resection: pathogenesis and its prevention
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/5c3f2c676b8c47bfa0e866c963c9e049
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Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention

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