Portal vein stenting for portal vein stenosis after pancreatoduodenectomy: A case report

Teruhisa Sakamoto, Yosuke Arai, Masaki Morimoto, Masataka Amisaki, Naruo Tokuyasu, Soichiro Honjo, Keigo Ashida, Hiroaki Saito, Shinsaku Yata, Yasufumi Ohuchi, Yoshiyuki Fujiwara

研究成果: ジャーナルへの寄稿学術論文査読

5 被引用数 (Scopus)

抄録

Portal vein stenosis, which results in serious clinical conditions such as gastrointestinal variceal bleeding and liver failure, is caused by hepatobiliary pancreatic cancer or major postoperative complications after hepatobiliary pancreatic surgery. In recent years, portal vein stenting under interventional radiology has been applied as a more useful treatment method for portal vein stenosis than invasive surgery. We herein report the successful use of a vascular stent for portal vein stenosis after pancreatoduodenectomy. A 66-year-old man with distal cholangiocarcinoma underwent subtotal stomach-preserving pancreatoduodenectomy with resection of the portal vein because of direct invasion to the main portal vein at our hospital. The portal vein was reconstructed without a venous graft. He developed jejunal bleeding near the pancreatojejunostomy on postoperative day (POD) 2. Although embolization of the responsible vessel achieved hemostasis, an intraoperatively inserted drainage tube was needed for a long period of time postoperatively because the embolized afferent jejunum was perforated. He was discharged on POD 39 after removal of the drainage tube. On POD 282, he was readmitted with melena and severe fatigue. Computed tomography revealed an obstruction of the reconstructed portal vein and varices at the hepaticojejunostomy site. We diagnosed variceal bleeding and performed percutaneous transhepatic stenting in the obstructed portal vein. The patient was discharged in good clinical condition on day 15 after stenting. In conclusion, portal vein stenting is a useful and less invasive therapy for portal vein stenosis.

本文言語英語
ページ(範囲)182-186
ページ数5
ジャーナルYonago Acta Medica
61
3
DOI
出版ステータス出版済み - 06-2018

All Science Journal Classification (ASJC) codes

  • 医学一般

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