Review Article

Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies

Table 1

Overview of included studies.

Authors (publication year)Type of researchCountryInterval of enrolmentEligibility criteria Type of disease (AP, CP, HP, or AIP)Number of total samplesSVTPVTSlpVTMVTMean age (range years)Female/
male

Sisman et al.  
(2014) [19]
Retrospective cohort studyTurkey2007–2011NACP6513NA13NANA14/51

Britton et al.  
(2014) [18]
Retrospective cohort studyUK1998–2012Exclusion criteria: 46 cases were excluded from the final analysis as imaging reports made no comment on the portal venous system.AP1459090NANA56.1NA

Talukdar et al.  
(2014) [47]
Prospective cohort studyIndiaAugust 2011 to October 2012Inclusion criteria: patients over 18 yrs with a primary diagnosis of first episode of AP from August 2011 to October 2012, and prospectively followed for at least six months after discharge or till death; exclusion criteria were (1) recurrent AP; (2) patient who did not get a CT scan.AP1631239NANA40/123

Easler et al.  
(2014) [38]
Prospective studyUSAJune 2003 and April 2010Inclusion criteria: SAP patients who were admitted with their first AP attack; exclusion criteria: patients with a history of AP or CP.AP16222819655 ± 2078/84

Castiñeira-Alvariño et al.  
(2013) [20]
Prospective study SpainSince 2007Inclusion criteria: patients with age <18 years at index visit to the CP outpatient clinic; exclusion criteria: patients who clearly modified the diet before the index visit were excluded.CP16855NANA44
(17–76)
40/128

Suero et al.  
(2013) [21]
Retrospective studySpainNANAAIP256NANANA (17–79)2/23

Marra-López et al.  
(2013) [22]
Prospective cohort studySpain2011–2013 Inclusion criteria: CP patients defined by M-ANNHEIM.CP859NA9/85NA59.3817/68

Harris et al.  
(2013) [2]
Retrospective studyUSAJanuary 1996 to December 2006Inclusion criteria: an institutional (Mayo clinic) database search was done using the key terms acute pancreatitis and superior mesenteric vein thrombosis (SMVT), portal vein thrombosis (PVT), and splenic vein thrombosis (SplVT) from January 1996 to December 2006; exclusion criteria: (1) patients with precipitating factors for thrombosis (abdominal surgery unrelated to ongoing pancreatitis, trauma, pregnancy, cirrhosis, intra-abdominal infections, pancreatic cancer, and primary myeloproliferative disorders) were excluded. (2) All cases of chronic pancreatitis were also excluded.AP245445203017NANA

Jakchairoongruang and Arjhansiri  
(2013) [48]
Retrospective studyThailandJanuary 1, 2005 and April 30, 2010Exclusion criteria: six hundred and eight patients were excluded from the study population because of the following reasons: it was not the first episode of acute pancreatitis, the initial CT was not performed, there are no available CT images on our Pictures Archiving and Communications System (PACS), or patient was imaged with only unenhanced CT.AP721NA1/72NA47.7
(6–89)
33/39

Ishikawa et al. (2012) [49]Retrospective studyJapanJuly 2003 and October 2010Inclusion criteria: patients who met the International Consensus Diagnostic Criteria (ICDC) for AIP.AIP5411NANA63.2 ± 13.5 (28–86)6/48

Sisman et al.  
(2012) [24]
Retrospective studyTurkey2007–2011Exclusion criteria: patients who received previous H. pylori eradication treatment and who are with any malignancy were excluded.CP6411NA11NANANA

De León et al.  
(2012) [25]
Retrospective studySpainNANAAIP164NA4NA 46.6 (17–73) 1/15

Vyas et al.  
(2012) [23]
Retrospective studyUKNANAAP8722NA12NANA35/52

Muddana et al.  
(2012) [39]
Prospective studyUSA2003–2010NAAP25141NA35NA51.5 ± 19123/128

Rebours et al.  
(2012) [17]
Prospective single-center studyFrance2000–2009Included criteria: all of the in- or outpatients with recurrent acute or chronic alcoholic pancreatitis and followed prospectively based on a standardized protocol, including a yearly physical examination and a search for exocrine pancreatic insufficiency, diabetes, and cholestasis; excluded criteria: (1) cirrhosis; (2) patients who were lost to follow-up in 2009.AP or CP11941143810NA19/100

Gonzelez et al.  
(2011) [15]
Retrospective studyUKJanuary 1, 2008, and December 31, 2009Excluded criteria: patients with chronic pancreatitis, known malignancy, cirrhosis, or established portal hypertension. AP127201014353.5 (36–81)118/9

Shalimar et al.  
(2011) [36]
Prospective studyUSANAInclusion criteria: patients with CP after an informed consent and ethical clearance; exclusion criteria: NA.CP2269NA9NANA48/178

Huggett et al.  
(2011) [16]
Prospective studyUK2004–2010Inclusion criteria: patients with AIP and with a median follow-up from diagnosis of 32 months (range 0–76)AIP527NANANA 59
(26–85)
11/41

Chowdhury et al.  
(2011) [50]
Retrospective study IndiaJanuary 2005 and December 2009Inclusion criteria: children diagnosed with chronic pancreatitis (on imaging study). CP734NANANANA22/51

Chooklin and Hranat (2009) [26]Retrospective studyUkraineNANAAP204NA4NANA3/17

Vege et al.  
(2009) [37]
Retrospective studyUSA1989–2007Exclusion criteria: patients with preexisting portal hypertension were excluded. AP1155503294NANA

Keck et al.  
(2009) [27]
Retrospective studyGermanyIn Germany: 2001–2005; in USA: 1995–2005Excluded criteria: three patients whose predominant lesion was only a very dilated pancreatic duct and who were thus selected for lateral pancreaticojejunostomy.CP9314NA14NANA31/62

Raina et al.  
(2009) [5]
Retrospective study USA1998–2007Exclusion criteria: three other malignancies (gastric cancer, the recurrence of gastric adenocarcinoma, and pancreatic adenocarcinoma).AIP264NA4NA62.5 (23–86)9/17

Agarwal et al.  
(2008) [51]
Retrospective study IndiaJanuary 1996 and December 2005NACP15734NA34NANANA

Mortelé et al.  
(2004) [40]
Retrospective study USA17-month periodNAAP1004613191451 (12–80)47/53

Makowiec et al.  
(2004) [28]
Prospective studyGermany1994–2001Exclusion criteria: 12 patients with portal hypertension and 9 patients underwent splenectomy without splenic vein thrombosis.CP177NANA39NANANA

Pimentel et al.  
(2003) [41]
Retrospective study Brazil1989–2002NACP642NANANANA14/50

Malíková et al.  
(2002) [29]
Retrospective study Czech RepublicNANAAP40NA274NANA

Mortelé et al.  
(2001) [42]
Retrospective study USAApril 1996 and August 1997NAAP10019NA19NANA47/53

Sakorafas et al.  
(2000) [43]
Prospective studyUSA1976–1997NACP48434NA34NANANA

Dörffel et al.  
(2000) [30]
Prospective studyGermany38 monthsIncluded criteria: definite diagnosis of acute pancreatitis as detected by ultrasonography (US) and CT, elevated serum lipase and amylase, compatible clinical picture, onset of pain symptoms not more than 3 days before admission, no history of pancreatitis, and no deficiencies in antithrombin III, protein C, and protein S.AP189451128643 (19–80)49/140

Arotcarena et al.  
(1999) [31]
Prospective studyFranceApril 1993 to April 1996NACP49473NANANANANA

Tsushima et al.  
(1999) [52]
Retrospective study JapanApril 1993 and August 1997Included criteria: patients with AP underwent initial abdominal CT within 3 days after the onset of symptoms and received at least one additional CT examination thereafter; Excluded criteria: cases of traumatic or postoperative pancreatitisAP 251NA1NA53.4 ± 20.8 (25–83)7/18

Takase et al.  
(1997) [54]
Prospective studyJapanDuring the past 10 years Exclusion criteria: 6 patients underwent pancreatoduodenectomy or biopsy without the splenic vein specimensCP125NA5NA48.80/12

Friess et al.  
(1997) [32]
Retrospective study GreeceNANACP39721NANANANANA

Lin et al.  
(1997) [53]
Prospective studyTaiwan1976–1996NACP905NA5NANANA

Bernades et al.  
(1992) [6]
Prospective longitudinal StudyFranceJanuary 1980 and March 1990Inclusion criteria: patients who met the criteria of CP and who had been followed-up during observation; exclusion criteria: patients with cirrhosis. CP266351022340.5 (6–77)35/231

Nordback et al. (1989) [35]Retrospective study Finland1972–1986NAAP or CP12686224NANA

Rogers and Klatt  
(1989) [44]
Retrospective autopsy case-control study USAJanuary 1958 and December 1987 Inclusion criteria: cases were included for study if acute pancreatitis was the immediate or contributing cause of death and the portal venous system (both splenic and portal veins) was examined completely at autopsy. Exclusion criteria: patients were excluded from study if there had been a splenectomy or if chronic pancreatitis was present microscopically. AP7211NA11NANA20/52

Hofer et al.  
(1987) [45]
Prospective studyUSA1975–1985NACP5011NA11NA50 (13–75)24/26

Roesch et al.  
(1981) [33]
Retrospective study GermanyNANACP53127NA27NA42.549/482

Sibert (1978) [34]Retrospective study UKNANAHP72523NANANA

McElroy and Christiansen  
(1972) [46]
Retrospective study USANANAHP26532NANANA

Gross (1958) [7]Prospective studyUSA1956NAAP or CP1252NA1149 (6–75)34/91

NA: the data are not available; AP: acute pancreatitis; CP: chronic pancreatitis; HP: hereditary pancreatitis; AIP: autoimmune pancreatitis; SVT: splanchnic vein thrombosis; PVT: portal vein thrombosis; SlpVT: splenic vein thrombosis; MVT: mesenteric vein thrombosis.