Portal Vein Occlusion with Aberrant Left Gastric Vein Functioning as a Hepatopetal Collateral Pathway

Ishigami, Kousei; Sun, Shiliang; Berst, Matthew J.; Heery, Scot D.; Fajardo, Laurie L.

doi:10.1097/01.rvi.0000126810.67111.ca

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…Jejunal varices formed at the site of the choledochojejunostomy are often difficult to detect and treat by gastrointestinal endoscopy [3]. CT can be used to evaluate the anatomic variation of the portal vein [41].…”

Section: Discussionmentioning

confidence: 99%

Portal Vein Stenting for Jejunal Variceal Bleeding after Recurrence of Pancreatic Adenocarcinoma: A Case Report and Review of the Literature

Sugiyama

Hirakawa

Takeishi

et al. 2021

Interventional Radiology

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A 73-year-old woman with portal vein stenosis caused by tumor recurrence after pancreatoduodenectomy was treated with stent placement without embolization of the jejunal varix. Anticoagulation therapy using heparin followed by rivaroxaban was administered after the procedure. She continued to receive systemic chemotherapy as an outpatient. Neither restenosis nor stent thrombosis was observed after 7 months. Based on the presented case and literature review, portal vein stenting is an effective treatment option for jejunal variceal bleeding caused by malignant portal venous stricture after pancreaticoduodenectomy. Antithrombotic therapy following portal venous stenting is required to prevent stent thrombosis in the majority of cases, although it has a risk of inducing recurrent variceal bleeding. Adjunctive jejunal variceal embolization can possibly be omitted in selected cases to obtain sufficient portal-SMV flow reconstruction.

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Section: Discussionmentioning

confidence: 99%

Portal Vein Stenting for Jejunal Variceal Bleeding after Recurrence of Pancreatic Adenocarcinoma: A Case Report and Review of the Literature

Sugiyama

Hirakawa

Takeishi

et al. 2021

Interventional Radiology

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“…Пути коллатерального порто-портального и портосистемного кровотока при ВПГ были продемонстрированы с помощью мультидетектор-ной компьютерной томографии. Они включали желудочно-сальниковые вены, короткие желудочные вены, левую желудочную вену, левую ободочную вену и спонтанные спленоренальные шунты [20,21].…”

Section: результаты и обсуждениеunclassified

SELECTIVE DEVASCULARIZATION OF THE GASTRIC FUNDUS IN PATIENTS WITH CHRONIC PANCREATITIS AND HEPATIC PORTAL HYPERTENSION. Case Series Preliminary Report

Могилевец¹,

Гарелик²

2021

Hepatol and Gastroenterol

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Background. Making treatment / prevention decisions in bleeding from gastroesophageal varices in patients with subhepatic portal hypertension remains challenging and thus requires further research. Objective. To perform a preliminary analysis of the outcomes of selective devascularization of the gastric fundus in patients with chronic pancreatitis and subhepatic portal hypertension. Material and methods. Selective devascularization of the gastric fundus was performed in five patients (3 men and 2 women) aged 23 to 54 with chronic recurrent pancreatitis and subhepatic portal hypertension. In 2 patients, Roux-en-Y cystojejunostomy for pancreatic pseudocyst was performed as the main treatment, and in 3 patients - Frey's surgery. Selective devascularization of the gastric fundus was adjuvant to a draining surgery or a resection-draining one. Results. All patients underwent surgery successfully. The duration of the operation (Me [min; max]) was 205 [190; 255] min. The time spent in the Department of anesthesiology, resuscitation and intensive care comprised 1 [1; 2] days. Postoperative follow-up of these patients over the period of 17 - 58 months detected no recurrence of bleeding from gastric varices. Endoscopy performed a year after revealed a decrease in the size of esophageal varices in all patients. Conclusions. The proposed technique of selective devascularization of the gastric fundus is substantiated by numerous studies of the variant anatomy of venous outflow from the spleen in extrahepatic portal hypertension. This technique is regarded as adjuvant to a draining surgery or a resection-draining one in patients with chronic pancreatitis and subhepatic portal hypertension performed to prevent bleeding from gastric fundus varices. There should be noted the reproducibility of this surgical intervention, its effectiveness and safety. Further research on the efficiency of the technique using randomized controlled trials is required.

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Aberrant left gastric vein is associated with hepatic artery variations

Ünal

Karçaaltıncaba

2019

Abdom Radiol

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Portal Vein Occlusion with Aberrant Left Gastric Vein Functioning as a Hepatopetal Collateral Pathway

Cited by 5 publications

References 7 publications

Portal Vein Stenting for Jejunal Variceal Bleeding after Recurrence of Pancreatic Adenocarcinoma: A Case Report and Review of the Literature

Portal Vein Stenting for Jejunal Variceal Bleeding after Recurrence of Pancreatic Adenocarcinoma: A Case Report and Review of the Literature

SELECTIVE DEVASCULARIZATION OF THE GASTRIC FUNDUS IN PATIENTS WITH CHRONIC PANCREATITIS AND HEPATIC PORTAL HYPERTENSION. Case Series Preliminary Report

Aberrant left gastric vein is associated with hepatic artery variations

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