title: [Portal vein stenting for portal hypertension caused by local recurrence following hepato-pancreatoduodenectomy for bile duct cancer].
abstract: The patient was a 73-year-old man diagnosed with bile duct cancer. He underwent hepato-pancreatoduodenectomy and a combined resection of portal vein in July 2002. The post operative course was uneventful. In December 2003 he had a loss of consciousness, and was admitted to our hospital as an emergency patient. Abdominal CT scan and angiography revealed the presence of portal vein stenosis due to local recurrence of bile duct cancer resulting in portal hypertension. Thus, a metallic stent was placed in the portal vein to maintain portal blood flow. A non-covered metallic stent, 10 mm in diameter and 80 mm in length (SMART stent, Cordis Endovascular), was deployed through the stenotic portal vein. Portography after the stent placement showed a relief of the portal vein stenosis. Intravenous heparin administration was performed at a dose of 5,000 IU per day for 5 days after the stent placement, and this was followed by oral warfarin potassium administration. The clinical course was uneventful and the patient was discharged 21 days after portal stent placement. Portal stenting successfully improved portal hypertension due to stenosis of the portal vein without any complication. Our experience suggests that the portal vein stenting using the SMART stent is useful palliative therapy for portal vein stenosis.
authors.affiliation: Dept. of General Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Jun
authors.initials: J
authors.lastname: Kawamoto
authors.forename: Fumio
authors.initials: F
authors.lastname: Kimura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshitome
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ambiru
authors.forename: Masayuki
authors.initials: M
authors.lastname: Otsuka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Katou
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nozawa
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Sawada
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Dan
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D016577:Pancreaticoduodenectomy; D011169:Portal Vein; D011183:Postoperative Complications; D015607:Stents; D016896:Treatment Outcome