{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T16:26:09Z","timestamp":1771863969177,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T00:00:00Z","timestamp":1488499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T00:00:00Z","timestamp":1488499200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In pancreaticoduodenectomy (PD) with resection of portal vein (PV)\/superior mesenteric vein (SMV) confluence, the splenic vein (SV) division may cause left\u2010sided portal hypertension (LPH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 88 pancreatic ductal adenocarcinoma patients who underwent PD with PV\/SMV resection after chemoradiotherapy were classified into three groups: both SV and splenic artery (SA) were preserved in Group A (<jats:italic>n<\/jats:italic> = 16), SV was divided and SA was preserved in Group B (<jats:italic>n<\/jats:italic> = 58), and both SV and SA were divided in Group C (<jats:italic>n<\/jats:italic> = 14). We evaluated the influence of resection of SV and\/or SA on LPH after PD with resection of PV\/SMV confluence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of postoperative varices in Groups A, B and C was 6.3, 67.2 and 38.5%, respectively (<jats:italic>p<\/jats:italic> &lt; 0.001), and variceal bleeding occurred only in Group B (<jats:italic>n<\/jats:italic> = 4: 6.8%). In multivariate analysis, Group B was the only significant risk factor for the development of postoperative varices (Groups B vs. A: odds ratio = 39.6, <jats:italic>p<\/jats:italic> = 0.001, Groups C vs. A: odds ratio = 8.75, <jats:italic>p<\/jats:italic> = 0.066). The platelet count ratio at 6\u00a0months after operation comparing to preoperative value was 0.93, 0.73 and 1.09\u00a0in Groups A, B and C, respectively (Groups B vs. C: <jats:italic>p<\/jats:italic> &lt; 0.05), and spleen volume ratio at 6\u00a0months was 1.00, 1.37 and 0.96\u00a0in Groups A, B and C, respectively (Groups B vs. A and C: <jats:italic>p<\/jats:italic> &lt; 0.01 and <jats:italic>p<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In PD with resection of PV\u2013SMV confluence, the SV division causes LPH, but the concomitant division of SV and SA may attenuate it.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-3916-8","type":"journal-article","created":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T17:34:55Z","timestamp":1488562495000},"page":"2111-2120","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Significance of Simultaneous Splenic Artery Resection in Left\u2010Sided Portal Hypertension After Pancreaticoduodenectomy with Combined Portal Vein Resection"],"prefix":"10.1002","volume":"41","author":[{"given":"Kazuyuki","family":"Gyoten","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Transplant Surgery Mie University School of Medicine 2\u2010174 Edobashi 514\u20108507 Tsu Mie Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shugo","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Transplant Surgery Mie University School of Medicine 2\u2010174 Edobashi 514\u20108507 Tsu Mie Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motonori","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Radiology Mie University School of Medicine 2\u2010174 Edobashi 514\u20108507 Tsu Mie Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Ogura","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center Mie University Hospital 2\u2010174 Edobashi 514\u20108507 Tsu Mie Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanobu","family":"Usui","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Transplant Surgery Mie University School of Medicine 2\u2010174 Edobashi 514\u20108507 Tsu Mie Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuji","family":"Isaji","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Transplant Surgery Mie University School of Medicine 2\u2010174 Edobashi 514\u20108507 Tsu Mie Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,3]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e31827b2d7c"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31815aab22"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000059"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9707"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010013\u20100595\u20101"},{"issue":"2","key":"e_1_2_6_7_2","first-page":"155","article-title":"A splenic\u2010inferior mesenteric venous anastomosis prevents gastric congestion following pylorus preserving pancreatoduodenectomy with extensive portal vein resection for cancer of the head of the pancreas","volume":"82","author":"Tamura K","year":"1997","journal-title":"Int Surg"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.688"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010014\u20103048\u2010z"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2014.03.010"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.03.007"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/219038"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010011\u20100440\u20103"},{"key":"e_1_2_6_14_2","unstructured":"National Comprehensive Cancer Network Practice Guidelines in Oncology.Pancreas Adenocarcinoma. 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