Prophylactic splenectomy for splenic vein thrombosis in patients undergoing resection for chronic pancreatitis

Zentralblatt für Chirurgie
F MakowiecU Adam

Abstract

Chronic pancreatitis (CP) is the leading cause of splenic vein thrombosis (SVT). SVT occurs in about 15 % of patients with CP. The risk of variceal bleeding in SVT is approximately 10 %. Splenectomy is indicated in symptomatic SVT but its role in asymptomatic SVT is discussed controversially. Aim of our study was to evaluate the outcome of splenectomy performed during pancreatic resection in patients with CP and asymptomatic SVT. 33 of 198 patients undergoing resection for CP underwent concomitant prophylactic splenectomy for asymptomatic SVT. Perioperative data were compared in the groups of patients with or without splenectomy. Follow-up was complete in 84 % (average 31 months). Median operative time, postoperative morbidity, reoperation rate and mortality were not different in patients with or without splenectomy. The median number of blood units transfused was higher in patients with prophylactic splenectomy (6 vs 4 units; p < 0.01). One complication of splenectomy (postoperative bleeding) occurred (3 %). During follow-up no variceal bleeding, no episode of postsplenectomy sepsis or thrombosis due to temporary thrombocytosis occurred. Complications of prophylactic splenectomy are rare and less frequent than reported episode...Continue Reading

Citations

May 21, 2005·Chinese Journal of Digestive Diseases·Quan Da LiuMao Qiang Wang
Nov 16, 2011·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·James R ButlerThomas J Howard

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