Secondary Left-sided Portal Hypertension and Radical Operations and Prognosis in Pancreatic Cancer Cases

Left-sided portal hypertension (LSPH), also known as sinistral or segmental portal hypertension, is associated with esophagogastric varices extending from the lower esophagus to greater curvature of the gastric body (Wang et al., 2012). It mainly occurs as a result of isolated thrombosis or obstruction of the splenic vein brought out by pancreatic disorders, and is one of the rare causes of upper digestive tract bleeding (Ito et al., 2008). Over the past 10 years, a few cases were reported about the failure of radical operation for patients with pancreatic cancer and secondary LSPH, and some surgeons considered the secondary LSPH as a potential risk for failure of radical operation (Shah et al., 2003; Yamaguchi et al., 2005; Strasberg et al., 2012). With the development of diagnostic sensitivity and surgical skill, both the preoperational diagnostic rate of LSPH and radical operation rate of pancreatic cancer have been improved. However, due to lack of randomized trials for evaluating the challenges brought by secondary LSPH, the role and efficacy of radical operation for patients with pancreatic cancer in