title: Preoperative trans-jugular porto-systemic shunt for oncological gastric surgery in a cirrhotic patient.
abstract: Abdominal surgery in cirrhotic patients with portal hypertension is associated with high incidence of disease and mortality. In these patients, oncological gastric procedures with lymph-nodes dissection show much higher complication rates than in normotensive portal vein patients. Thus, normalization of portal vein pressure may be a favorable determinant factor to reduce complications. We report a case of a patient with hepatitis C virus-related hepatic cirrhosis, esophageal varices, portal hypertension and gastric cancer. We demonstrated the efficacy of a preoperative trans-jugular porto-systemic shunt to perform oncological radical resection more safely. We retained preoperative the trans-jugular porto-systemic shunt in the patients with elevated portal pressure and gastric cancer to perform a gastrectomy more safely and to decrease morbidity and mortality of these cases.
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Liverani
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Solinas
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Di Cesare
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Velari
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Neri
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cilurso
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Favi
authors.affiliation: Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bizzarri
mesh_terms: D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000821:virology; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery* / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D017082:Portal Pressure; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011172:Portography; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: Cirrhotic patients; Esophageal varices; Gastric cancer; Gastric surgery; Portal hypertension; Trans-jugular porto-systemic shunt