title: Non-lethal Right Liver Atrophy After TIPS Occlusion in A Cirrhotic Patient: Introducing The Hepatic Biembolization.
abstract: Transjugular intrahepatic portosystemic shunt (TIPS) is the standard procedure in the treatment of refractory ascites and variceal bleeding in the setting of portal hypertension. Secondary obstruction of the shunt is a classic but potentially lethal complication.
  
  
  
  We present here the case of a cirrhotic patient that underwent a TIPS for refractory ascites, with early complete thrombosis without lethal complication.
  
  
  
  Obstruction of the TIPS led to thrombosis of both the right hepatic and the right portal veins with progressive total atrophy of the right liver and marked hypertrophy of the left liver. Despite initial poor liver function, biological hepatic markers improved slowly until complete recovery.
  
  
  
  Hence, we suggest the concept of combined right portal and hepatic vein embolization as a new procedure to induce partial liver hypertrophy before major liver resection, even in cirrhotic patients.
authors.affiliation: Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France. leroybertrand8@gmail.com.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Le Roy
authors.affiliation: Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.
authors.forename: Johan
authors.initials: J
authors.lastname: Gagnière
authors.affiliation: Department of Vascular Radiology, Gabriel Montpied Hospital, CHU Clermont-Ferrand, Place Henri Dunant, 63000, Clermont-Ferrand, France.|Faculty of Medicine from Clermont-Ferrand, UMR Auvergne CNRS 6284, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Chabrot
authors.affiliation: Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Pezet
authors.affiliation: Department of Hepatology, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.|Faculty of Medicine from Clermont-Ferrand, UMR Auvergne CNRS 6284, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.affiliation: Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.|Faculty of Medicine from Clermont-Ferrand, UMR Auvergne CNRS 6284, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Buc
mesh_terms: D001201:Ascites / Q000209:etiology / Q000601:surgery; D001284:Atrophy / Q000209:etiology; D004621:Embolization, Therapeutic; D006503:Hepatic Veins; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D006984:Hypertrophy / Q000209:etiology; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications; D011169:Portal Vein; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D013927:Thrombosis / Q000209:etiology*
keywords: Biembolization; Cirrhosis; Hepatectomy; Hypertrophy; TIPS; Thrombosis