Mariethoz S, Savioz D, Bühler L, Becker C, Morel P
Département de radiologie, Hôpitaux Universitaires de Genève.
Schweiz Med Wochenschr. 1998 May 30;128(22):867-70.
10% of chronic pancreatitis (CP) cases are complicated by splenic vein thrombosis (SVT) which is responsible for upper digestive haemorrhages. To improve our approach to treatment we reviewed 30 cases of SVT associated with CP treated in our centre from 1985 to 1995. 14 patients were treated conservatively. Six of them were refused for surgery due to extension of splenic vein thrombosis into the portal vein. Two patients without extrinsic compression of the vein were treated with anticoagulants. 16 patients were treated by surgery with low morbidity and without mortality. The standard treatment in fourteen cases was splenopancreatectomy. The average follow-up of seven years shows that these patients have preserved their body mass index (BMI). The results suggest that early surgical intervention is beneficial in preventing progression of SVT to the portomesenteric vein.
10%的慢性胰腺炎(CP)病例并发脾静脉血栓形成(SVT),这是上消化道出血的原因。为改进我们的治疗方法,我们回顾了1985年至1995年在本中心治疗的30例与CP相关的SVT病例。14例患者接受了保守治疗。其中6例因脾静脉血栓扩展至门静脉而被拒绝手术。2例无静脉外部压迫的患者接受了抗凝治疗。16例患者接受了手术治疗,发病率低且无死亡病例。14例的标准治疗方法是脾胰切除术。平均七年的随访表明这些患者保持了他们的体重指数(BMI)。结果表明早期手术干预有利于防止SVT进展至门静脉肠系膜静脉。