Diagnosis and surgical treatment of pancreatic sinistral portal hypertension ZHANG Tai-ping, ZHAN Han-xiang, ZHAO Yu-pei. Department of Surgery, Peking Union Medical College Hospital , Beijing 100730, China Corresponding author: ZHANG Tai-ping, E-mail: tpingzhang@yahoo.com Abstract Pancreatic sinistral portal hypertension (PSPH) is a rare type of portal hypertension. Splenic vein thrombosis or obstruction are its fundamental causes.Its primary diseases include pancreatitis,pancreatic tumors and other pancreas diseases.It can provoke a simple portal vein higher pressure on the spleen and stomach region. The diagnosis of PSPH is based on clinical, biochemical, and radiological evaluation. It should follow individualized principles for the management of PSPH:Treatment of pancreatic disease is the basis and key of PSPH. Splenectomy is the management of choice for cases complicated by variceal bleeding.Pericardial devascularization process is needed if the severe gastric varices are found. Splenectomy should be added to the pancreatic procedure in patients whose pancreatic diseases locate in the body or tail of pancrease, but preventive splenectomy is not recommended. Interventional therapy is suitable for those patients who can not tolerate the operation.