[Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy].

Abstract

Here, we report a case of Hassab's operation for left-sided portal hypertension after pancreatoduodenectomy. A 69-year old man underwent pancreatoduodenectomy for pancreatic cancer in 2006 in which the splenic vein was ligated near the portal vein and then divided. The patient suffered repeated episodes of anemia between 2010 and 2013. However, we could not identify the bleeding site at that time. In 2011, local recurrence was detected. Disease progression occurred despite chemotherapy treatment, which was then discontinued. The left-sided portal hypertension gradually progressed, and the collateral vessels became dilated. In 2014, he was examined in our department for gastrointestinal bleeding. An upper gastrointestinal endoscopy revealed bleeding from gastric varices. Gastrointestinal bleeding ceased after endoscopic injection sclerotherapy ( EIS) was performed; however, the bleeding recurred. Balloon retrograde transvenous occlusion (BRTO) could not be performed because blood flow was not detected within the gastro-renal shunt. An emergency surgery was performed. Surgical splenectomy and devascularization (Hassab's operation) were performed. After surgery, the gastric body varices and gastrointestinal anastomosis disappeared and the bleeding did not occur. He is currently receiving outpatient treatment.

• Authors: Tadahiro Goto, Ippei Matsumoto, Makoto Shinzeki, Hirochika Toyama, Sadaki Asari, Azusa Ueta, Jun Ishida, Yoshihide Nanno, Shinichi So, Hisoka Kinoshita, Taku Matsumoto, Kaori Kuramitsu, Motofumi Tanaka, Atsushi Takebe, Masahiro Kido, Tetsuo Ajiki, Takumi Fukumoto, Yonson Ku
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 41 Issue 12 Pg. 2214-6 (Nov 2014) ISSN: 0385-0684 [Print] Japan
• PMID: 25731474 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antineoplastic Agents

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• Gastrointestinal Hemorrhage (etiology, surgery)
• Humans
• Hypertension, Portal (etiology, surgery)
• Male
• Pancreatic Neoplasms (drug therapy, surgery)
• Pancreaticoduodenectomy (adverse effects)
• Portal Vein (pathology, surgery)
• Recurrence
• Treatment Outcome