title: Percutaneous transhepatic stent placement in the management of portal venous stenosis after curative surgery for pancreatic and biliary neoplasms.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy and safety of stent placement in the management of portal venous stenosis after curative surgery for pancreatic and biliary neoplasms.
  
  
  METHODS
  From September 1995 to April 2007, percutaneous transhepatic portal venous stent placement was attempted in 19 patients with postoperative portal venous stenosis. Portal venous stenosis was a complication of surgery in 11 patients and caused by tumor recurrence in eight patients. The clinical manifestations were ascites, hematochezia, melena, esophageal varices, and abnormal liver function. Stents were placed in the stenotic or occluded lesions after percutaneous transhepatic portography. Technical and clinical success, stent patency, and complications were evaluated.
  
  
  RESULTS
  Stent placement was successful in 18 patients (technical success rate, 95%). Clinical manifestations improved in 16 patients (clinical success rate, 84%). The mean patency period among the 18 patients with technical success was 21.3 ± 23.2 months. The mean patency period of the benign stenosis group (30.1 ± 25.6 months) was longer than that of the tumor recurrence group (7.3 ± 7.7 months), and the difference was statistically significant (p = 0.038). There were two cases of a minor complication (transient fever) and three cases of major complications (septicemia, liver abscess, and acute portal venous thrombosis).
  
  
  CONCLUSIONS
  Percutaneous transhepatic stent placement can be safe and effective in relieving portal venous stenosis after curative surgery for pancreatic and biliary neoplasms. Patients with benign stenosis had more favorable results than did those with tumor recurrence.
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Kyung Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010190:Pancreatic Neoplasms / Q000601:surgery; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome