Stent placement for portal venous stenosis following major abdominal surgery

Background/Aims: This study was retrospectively undertaken to evaluate clinical utility of portal venous stent placement in the treatment of portal venous stenosis after major abdominal surgery combined with portal reconstruction. Methodology: Portal venous stent placement was done in 4 consecutive patients with anastomotic portal venous stenosis following major abdominal surgery combined with portal reconstruction. liver dysfunction developed in all patients and consciousness loss in one patient, 1-55 days (mean, 19 days) after surgical intervention. Portal venous blood flow was not recognized by Doppler ultrasonographic studies in all patients. Expandable metallic stents were placed in the portal vein by percutaneous transhepatic approach in 2 patients and by transil-iac approach in the other 2 patients. Results: Stents were successfully placed across the anastomotic stenosis in all patients. Portal venous blood flow restored immediately after stent placement and liver dysfunction and consciousness loss resolved. Portal venous blood flow was maintained during the follow-up period ranging from 99 days to 765 days (mean, 438 days) in all patients. Conclusions: Portal venous stent placement is a useful therapeutic option for the treatment of anastomotic stenosis of portal vein following major abdominal surgery combined with portal recon' struction.