title: [Successful Treatment of Stenosis of the Portal Vein Using an Expandable Metallic Stent after Extended Right Hepatectomy--A Case Report].
abstract: We report successful treatment of stenosis of the portal vein caused by enlargement of the remnant liver after extended right hepatectomy with interventional radiology using an intraportal expandable metallic stent (EMS). A 75-year-old man underwent extended right hepatectomy after percutaneous transhepatic right portal embolization for advanced gallbladder cancer. His portal vein branched out into the anterior, posterior, and left branches. The main portal vein and left branch formed a sharp angle by nature. We ligated the posterior branch and sutured the cut line of the anterior branch during surgery. Several days after the surgery, icterus and massive ascites developed. Computed tomography (CT) and portography showed thrombi and stenosis of the cut line of the right branches due to enlargement of the remnant liver. A covered EMS was placed at the stenosis with interventional radiology. After stent placement, the icterus and massive ascites resolved. The patient remains well and EMS has caused no difficulty for 19 months. Intraportal EMS placement is effective in treating perioperative portal venous complications.
authors.affiliation: Dept. of Surgery, North Medical Center, Kyoto Prefectural University of Medicine.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Masato
authors.initials: M
authors.lastname: Mitsuda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Toma
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic / Q000628:therapy*; D004621:Embolization, Therapeutic; D005706:Gallbladder Neoplasms / Q000150:complications / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008297:Male; D011169:Portal Vein; D015607:Stents