Management of gastric cancer in patients with sinistral portal hypertension
Sinistral portal hypertension (SPH) is usually caused by pancreatic pathology and is characterized by splenic vein thrombosis with or without portal vein thrombosis.1 The increased pressure caused by splenic vein occlusion is transmitted via the short gastric and gastroepiploic veins to the portal system.The reversal of blood flow in the left gastric vein results in gastric varices.In patients with SPH,especially those with occlusion of both the splenic and portal veins,the main or even the only pathway of splenic venous return to the portal vein is via the gastric varices,and these patients require special management during gastric surgery.
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