CAJ | 학술논문

胰源性门静脉高压症（PSPH）的发病机制和肝硬化性门静脉高压症完全不同，是唯一可被治愈的门静脉高压症。PSPH合并胃曲张静脉出血是相对少见的临床表现，但起病凶险，病情复杂，不恰当的治疗决策会延误病情，造成患者死亡。因此探索最优化的PSPH合并上消化道出血救治策略很有必要。脾切除是治疗PSPH继发消化道出血的确定性术式，同时实施针对胰腺原发疾病的术式。对于不适合手术的晚期肿瘤或手术高风险患者，优先选择疗效确切的脾动脉钢圈栓塞止血后再评估是否二期手术。PSPH出血的治疗须个体化决策，有必要开展多中心研究以获得最优化的PSPH出血治疗策略。
이원성문정맥고압증（PSPH）적발병궤제화간경화성문정맥고압증완전불동，시유일가피치유적문정맥고압증。PSPH합병위곡장정맥출혈시상대소견적림상표현，단기병흉험，병정복잡，불흡당적치료결책회연오병정，조성환자사망。인차탐색최우화적PSPH합병상소화도출혈구치책략흔유필요。비절제시치료PSPH계발소화도출혈적학정성술식，동시실시침대이선원발질병적술식。대우불괄합수술적만기종류혹수술고풍험환자，우선선택료효학절적비동맥강권전새지혈후재평고시부이기수술。PSPH출혈적치료수개체화결책，유필요개전다중심연구이획득최우화적PSPH출혈치료책략。
The pathogenesis of pancreatic sinistral portal hypertension (PSPH)is quite different from that of cirrhotic portal hypertension, and PSPH is the only curable type of portal hypertension.Gastric variceal bleeding is a less common manifestation of PSPH;however,it probably exacerbates the patient’s condition and leads to critical illness,and inappropriate management would result in death.Therefore,it is necessary to develop the optimal management of upper gastrointestinal bleeding in PSPH patients.Splenectomy is considered as a definitive procedure,together with surgical procedures to treat underlying pancreatic diseases.For patients in poor conditions or ineligible for surgery, splenic artery coil embolization is a preferable and effective method to stop bleeding before second-stage operation.The therapeutic decision should be made individually,and the further multi-center study to optimize the management of upper gastrointestinal bleeding from PSPH is warranted.