Left-sided portal hypertension secondary to pancreatic cancer: clinical features, surgical treatment and outcome of 48 cases.

Background/aims: Features of LSPH secondary to pancreatic cancer is ambiguous, and controversy remains in the treatment.

Methods: 48 cases from our department were retrospectively analyzed to evaluate the clinical features, as well as the feasibility and effect of surgical treatment.

Results: 16 patients had gastrointestinal hemorrhage history. Laboratory findings showed normocytic and normochromic anemia, thrombocytopenia, lymphocyte reduction, and elevated liver enzyme. Tumor markers were normal in 12 patients. Ultrasonography showed splenic venous obstruction in 40 patients and splenomegaly in 35. Esophagogastric varices could be detected by endoscopy in 40 patients and by CT in 37. Radical resection was performed in 43 patients and splenectomy or additional devascularization in 29. 15 patients had gastrointestinal bleeding during follow-up, and the median survival time was 11.0 months.

Conclusion: Associated LSPH brought special features to pancreatic cancer. Radical resection, as well as splenectomy or additional devascularization for varices above Grade II, was worth performing.