Treatment of massive variceal bleeding secondary to localized pancreatitis-associated portal hypertension
10.3760/cma.j.issn.1007-8118.2016.12.007
- VernacularTitle:胰腺炎相关区域性门静脉高压伴上消化道大出血的治疗
- Author:
Zhengming LEI
;
Jiaqi DENG
;
Wenguang FU
;
Jing LI
- Keywords:
Portal hypertension,localized;
Massive upper gastrointestinal hemorrhage;
Pancreatitis;
Pancreatic pseudocyst
- From:
Chinese Journal of Hepatobiliary Surgery
2016;22(12):819-821
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study treatment of massive variceal bleeding secondary to localized pancreatitis-associated portal hypertension (MVBPAPH).Methods A retrospective study on the clinical data of patients with MVBPAPH was carried out.Of 24 patients with MVBPAPH,20 had pancreatic pseudocysts.12 were operated after failure of treatment with endovascular intervention for variceal bleeding (including 10 patients with splenectomy and gastric fundus-body peripheral vessels amputation and 2 patients with pancreatic pseudocystogastrostomy).8 patients underwent partial splenic embolization and left gastroepiploic artery embolization.4 patients directly underwent splenectomy and gastric fundus-body peripheral vessels amputation for variceal bleeding.Results Left pleural effusion developed in 5 patients who underwent arterial embolization.Left pleural effusion and lung infection occurred in 2 patients who underwent operation.All patients recovered well and were discharged home.During the follow-up period of 2 to 72 months,no rebleeding occurred in these patients (including 2 patients had passed little interval melena).Gastroscopy re-examination showed that variceal veins were not found in 18 patients.Variceal veins which were detected in the remaining 6 patients were obviously less severe.Conclusion Individualized treatment should be given to patients with MVBPAPH and according to the specific type of pancreatitis and the onset time of any accompanying pseudocyst.
