Clinical Analysis Of Pancreatic Sinistral Portal Hypertension In 42 Cases

Objective:To summarize the pathogenesis,diagnostic method,and treatment methods of pancreatic sinistral portal hypertension(PSPH),and to further improve the level of treatment.Methods:The clinical data of 42 patients with pancreatic sinistral portal hypertension in the First Affiliated Hospital of Xin jiang Medical University from December 2012 to December 2017 were analyzed retrospectively.We needed to analyze the the etiology,diagnosis and treatment of the patients.Results:The primary diseases of PSPH: pancreatic tumors(38%),chronic pancreatitis(26%),acute pancreatitis(14%),pancreatic pseudocyst(12%),after the operation of the pancreas(10%).In this group,25 of the 42 patients with PSPH underwent surgical treatment(including 7 cases of patients with distal pancreatic resection combined with spleen,4 cases of patients with splenectomy and internal drainage of pancreatic pseudocysts and vascular dissection around the fundus of the stomach,1 patients with splenectomy and vascular dissection around the fundus of the stomach,5cases of patients with splenic artery embolization,1cases of patients with splenectomy and pancreaticoduodenectomy,1 cases of patients with splenectomy and internal drainage of pancreatic pseudocysts,6 cases of patients with splenectomy).In other cases,2 cases of patients with pancreatic malignant tumor in the advanced stage of cancer,the patients abandoned treatment,3 cases of patients with pancreatic malignant tumor were treated with chemotherapy.16 patients were treated conservatively.39 patients were followed up effectively.The rate of follow-up was 92%.After operation,the clinical symptoms were relieved.During the follow-up period,the upper gastrointestinal bleeding did not occur after operation and the degree of hypersplenism did not increase significantly.Conclusion:PSPH has a variety of clinical manifestations and the causes of complications are complex.The splenectomy of patients with PSPH was difficult to operate and had a high risk.If patients with gastrointestinalbleeding were involved,it is recommended to perform splenic artery embolization first,and then perform secondary splenectomy at the later stage.