Sinistral portal @entity101 after pancreaticoduodenectomy with XXXX .

@entity1 @entity788 @entity101 @entity1184 @entity4558 @entity694 @entity360
BACKGROUND: Splenic vein ligation may result in sinistral (left-sided) portal @entity101 and @entity360 . The aim of this study was to analyse the pathogenesis of sinistral portal @entity101 following @entity4558 in pancreaticoduodenectomy. METHODS: @entity1 who underwent pancreaticoduodenectomy for @entity788 between January 2005 and December 2012 were included in this retrospective study. The venous flow pattern from the spleen and @entity1184 were examined after surgery. RESULTS: Of 103 @entity1 who underwent pancreaticoduodenectomy with portal vein resection, 43 had @entity4558 . There were two predominant venous flow patterns from the spleen. In the varicose route (27 @entity1 ), flow from the spleen passed to @entity694 . In the non-varicose route, flow from the spleen passed through a splenocolonic collateral (14 @entity1 ) or a spontaneous splenorenal shunt (2 @entity1 ). The varicose route was associated with significantly greater @entity1184 than the non-varicose route (median @entity1184 ratio 1  52 versus 0  94; P   <   0  001). All @entity1 with the varicose route had colonic varices, and none had a right colic marginal vein at the hepatic flexure. CONCLUSION: Pancreaticoduodenectomy with @entity4558 may lead to sinistral portal @entity101 . To avoid the development of varices, it is important to preserve the right colic marginal vein. Reconstruction of the splenic vein should be considered if the right colic marginal vein is divided.
