Risk Factors, Management, and Outcome of Gastric Venous Congestion After Total Pancreatectomy: An Underestimated Complication Requiring Standardized Identification, Grading, and Management

. 2023 Aug 19;30(12):7700–7711. doi: 10.1245/s10434-023-13847-z

Intraoperative gastric venous congestion: procedural details

	(Sub)total gastrectomy
Variable	Yes	No	p value
	(n = 29)	(n = 24)	p value
TP type, n (%)			1.000^a,b
Single-stage elective	28 (96.6)	24 (100)
Preoperatively planned	6 (20.7)	9 (37.5)
Intraoperatively decided	22 (75.9)	15 (62.5)
Elective completion	1 (3.4)	0 (0)
Pylorus preservation, n (%)	–	2 (8.3)	–
Spleen preservation, n (%)	0 (0)	1 (4.2)	0.453^a
Ligation splenic vein, n (%)	29 (100)	23 (95.8)	0.453^a
Ligation left coronary vein, n (%)	22 (75.9)	12 (50.0)	0.051^c
Ligation splenic vein + left coronary vein, n (%)	22 (75.9)	12 (50.0)	0.051^c
Vascular resection, n (%)	22 (75.9)	12 (50.0)	0.051^c
Portomesenteric venous resection			0.062^a
Type 1−2	1 (3.4)	3 (12.5)
Type 3−4	20 (69.0)	9 (37.5)
Arterial resection^d	6 (20.7)	0 (0)	0.027 ^a
Hepatic artery	5 (17.2)	0 (0)	0.056^a
Superior mesenteric artery	1 (3.4)	0 (0)	1.000^a
Venous + arterial resection	5 (17.2)	0 (0)	0.056^a
Multivisceral resection other than gastric resection, n (%)	2 (6.9)	2 (8.3)	1.000^a

Bold value indicates statistical significance (p < 0.050)

TP, total pancreatectomy

^aFisher’s exact test, ^bSingle-stage elective vs elective completion, ^cChi-square test, ^dAll arterial resections are reconstructed