[Intrahepatic portacaval anastomosis by the transjugular approach. Use of the Palmaz endoprosthesis].
This new, non-operative procedure has been devised to create an intrahepatic shunt between a main portal branch and the right hepatic vein. First, the portal bifurcation is located by sagittal sonography and its position is marked on the skin. Then one of the main portal branches is punctured from the right hepatic vein by the transjugular route, and the puncture tract is expanded by balloon dilatation. This channel is kept open by placement of one or several Palmaz stents. Ten cirrhotic patients (age range: 60-84 years) unfit for surgical portocaval shunting and presenting with recurrent variceal bleeding after sclerotherapy were successfully treated by this method without any related death. During a 1 to 8 months follow-up, 9 of the 10 shunts have remained perfectly patent, but more time is required to determine the place of this method for secondary management of cirrhotic variceal bleeding.
Perarnau
J M
JM
Service de Médecine B, Hôpital Bon Secours, CHR Metz-Thionville.
Noeldge
G
G
Rössle
M
M
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D015607:Stents
Anastomose porto-cave intra-hépatique par voie transjugulaire. Utilisation de l'endoprothèse de Palmaz.