Percutaneous Transhepatic Stent Placement in the Management of Portal Venous Stenosis After Curative Surgery for Pancreatic and Biliary Neoplasms

Abstract

Percutaneous transhepatic stent placement can be safe and effective in relieving portal venous stenosis after curative surgery for pancreatic and biliary neoplasms. Patients with benign stenosis had more favorable results than did those with tumor recurrence.

Stent Placement for Portal Vein Stenosis After Pancreaticoduodenectomy

“…[8][9][10][13][14][15][16][17][18][19].Olcott et al reported the first case after liver transplantation in 1990 [20], and Hiraoka et al reported the first case of PV stenosis after PD in 2001…”

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

“…Once again, in our patient, the number of collaterals was less than that of normal blood vessels after the pancreatoduodenectomy because of dissection, extended lymphadenectomy and skeletonisation of the vasculature [22]. Need to restore portal flow After pancreatoduodenectomy, re-exploration around the portal vein might be limited due to the presence of adhesions, the length of the involved portal vein segment, and increased risk of hepatic artery injury [23].…”

“…Although portosystemic shunt procedures can offer long-term protection from variceal haemorrhage and refractory ascites [5,24,25], the operative mortality rate [22], especially in a septic context, and the incidence of adverse effects, including a decrease in intrahepatic portal flow or development of post-shunt encephalopathy, are reported to be high [26].…”

Portal vein occlusion following pancreaticoduodenectomy and portal vein resection: treatment by percutaneous portal vein stent

“…4 We have used this technique successfully in a patient who experienced immediate acute liver failure one day after surgery due to a non-thrombotic occlusion of the portal vein following pancreaticoduodenectomy and vascular resection. The end-to-end anastomosis was twisted, causing a stenosis of the vein.…”