Risk Factors for Sinistral Portal Hypertension and Related Variceal Bleeding in Patients with Chronic Pancreatitis.

AIM Sinistral portal hypertension (SPH) is an uncommon complication of chronic pancreatitis (CP) and can result in severe gastrointestinal bleeding. The aim of this study was to determine the prevalence and the potential risk factors for SPH and related gastrointestinal variceal bleeding in CP patients. METHODS This is a case-control study. We retrospectively reviewed all patients with SPH due to CP admitted to our hospital from July 2014 to June 2019. The CP patients without SPH were randomly selected as control group during the study period (case: control  =  1:2 ratio). Demographic data, medical history, course of chronic pancreatitis, characteristics associated with SPH, and follow-up evaluations of patients were documented in detail. The prevalence rate of SPH in CP patients and the related gastrointestinal bleeding was calculated. Risk factors for SPH and related variceal bleeding were analyzed using univariate or multivariate logistic regression analysis. RESULTS The prevalence of SPH was 2.7% in CP patients (89/3358). The independent risk factors for SPH included alcohol consumption (P = 0.030), history of acute pancreatitis (P = 0.010), diabetes (P < 0.001), and pseudocysts (P < 0.001). There were 17 patients (19.1%) suffered from related gastrointestinal bleeding. Between bleeding and non-bleeding groups, there were significant differences in types of CP, stones existence, gastric varices diagnosed before bleeding, splenomegaly and hypersplenism by the univariate analysis. CONCLUSIONS SPH is a rare complication of CP and there is a relatively low risk of variceal bleeding among SPH patients. This article is protected by copyright. All rights reserved.