The transjugular stent implantation for the treatment of malignant portal and hepatic vein obstruction in cancer patients.
BACKGROUND
The increase in portal vascular resistance is a significant complication of metastatic disease to the liver or locally advanced cancer, e.g., biliary cancer.


METHODS
This paper describes the successful palliative treatment of two cancer patients with portal hypertension presenting with the symptoms of tense ascites, mesenteric congestion, and severe variceal bleeding. By creating a stenttract between a hepatic vein and a main branch of the portal vein and/or by placing an extendable stent into the portal vein, the transjugular intrahepatic portosystemic stent-shunt (TIPS) technique was used to decompress the portovascular system.


RESULTS
The TIPS-technique offers a new, safe and effective palliation for malignant portal hypertension. In both patients, the symptoms of the portal hypertension disappeared after the procedure. This was accompanied by a significant improvement of the patients performance status allowing an early ambulation.


CONCLUSIONS
Our findings demonstrate the feasibility and effectiveness of the TIPS procedure as a minimal invasive treatment for portal vein decompression in selected tumor patients.
Burger
J A
JA
Department of Medicine, Albert-Ludwigs-University School of Medicine, Freiburg, Germany.
Ochs
A
A
Wirth
K
K
Berger
D P
DP
Mertelsmann
R
R
Engelhardt
R
R
Roessle
M
M
Haag
K
K
D001661:Biliary Tract Neoplasms / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D015607:Stents