Gastric Varices after Spleen-Preserving Distal Pancreatectomy

Sho Yamada*, Kazuya Maeda and Yasuo Hashizume

Department of Surgery, Fukui Prefectural Hospital, Japan

^*Correspondance to: Sho Yamada 

 PDF  Full Text DOI: 10.25107/2474-1647.2835

Abstract

Introduction: Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) is indicated for benign and low-grade malignant tumors of the body and the tail of the pancreas. However, there are few reported cases of gastric varices requiring treatment after LSPDP with preservation of the splenic vessels. Case Presentation: A 44-year-old woman underwent LSPDP for a cystic pancreatic neoplasm in 2012. In 2017, an Esophagogastroduodenoscopy (EGD) performed at a health check-up revealed gastric varices that were red in color. A Computed Tomography (CT) scan revealed splenic vein occlusion, which caused the gastric varices. We performed laparoscopic splenectomy for the gastric varices. There were no gastric varices on the postoperative EGD or CT. Conclusion: We considered strongly drawing on the tape encircling the splenic vein and cutting the splenic vein branches without preserving its root with clip or energy device as the mechanism for splenic vein occlusion. Intraoperative procedures that affect the splenic vein must be carefully observed when performing LSPDP.

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Cite the article

Yamada S, Maeda K, Hashizume Y. Gastric Varices after Spleen-Preserving Distal Pancreatectomy. Clin Surg. 2020; 5: 2835.