Portal Vein Stenosis Caused by Postoperative Complications after Pancreatobiliary Surgery

Abstract

Background: Portal vein (PV) stenosis or obstruction is sometimes observed in patients who were performed pancreatobiliary surgery. These conditions such as pancreatic fistulas (PF) and intra-abdominal infections after pancreatobiliary surgery still represent significant clinical issues. In addition, insufficient attention is paid to the fact that severe stenosis of the PV can result in life-threatening complications. Material and Methods: At our institution, lymph node dissection within the hepatoduodenal ligament was performed for biliary or pancreatic neoplasms in 68 patients between October 2005 and April 2017. The diameter of the PV was measured on computed tomography scans obtained before and after the operation. PV stenosis was defined as a >50% reduction in the diameter of the PV. The degree of PF (Pancreatic Fistula) was defined by the International Study Group of Pancreatic Fistula after pancreaticoduodenectomy. Furthermore, the Clavien-Dindo (CD) classification was used to assess the complications that occurred in cases in which pancreatojejunostomy was not performed. The relationship between the degree of PV stenosis and the occurrence of postoperative complications was analyzed. Results: The overall frequency of PF was 56.3% (18 patients). Grade B or C PF occurred in 5 patients (15.6%). In the present small series, a correlation was detected between the degree of PV stenosis and the occurrence of postoperative complications after pancreatobiliary surgery (p < 0.05). Conclusions: Clinicians should keep in mind that the PV can narrow in cases in which grade B or C PF or intra-abdominal abscesses occur after pancreatobiliary surgery.

A biodegradable polymer stent with high radial performance: Potential for treatment of portal vein stenosis

“…4,5 This not only increases morbidity and mortality, but also affects the long-term quality life of patients. 6,7 PV stent placement is a feasible procedure for PVS. [8][9][10] Studies on the clinical efficacy of patients with malignant tumors or benign portal stenosis have shown that portal hypertension is improved, clinical symptoms are relieved, and the patency rate of stent implantation is 60%-100%.…”

“…It can result in heightened resistance to blood flow through the portal vein and a decrease in hepatic blood supply, thereby elevating pressure within the portal venous system and consequently leading to portal hypertension 4,5 . This not only increases morbidity and mortality, but also affects the long‐term quality life of patients 6,7 . PV stent placement is a feasible procedure for PVS 8–10 .…”