title: Portal vein stent placement for the treatment of postoperative portal vein stenosis: long-term success and factor associated with stent failure.
abstract: BACKGROUND
  Portal vein stenosis develops due to different causes including postoperative inflammation and oncological processes. However, limited effective therapy is available for portal vein stenosis. The objectives of this study were to evaluate the efficacy of a portal vein stent for portal vein stenosis after hepatobiliary pancreatic surgery and to determine the factors associated with stent patency.
  
  
  METHODS
  From December 2003 to December 2015, portal vein stents were implanted in 29 patients who had portal vein stenosis after hepatobiliary pancreatic surgery. We conducted a retrospective analysis to evaluate the efficacy and safety of portal vein stent placement. Twelve clinical variables were analyzed for their role in stent patency.
  
  
  RESULTS
  The symptoms before portal vein stent placements included nine patients with hepatic encephalopathy, six patients with gastrointestinal bleeding, four patients with ascites, and four patients with hyperbilirubinemia. Portal vein thrombosis due to postoperative portal stenosis was found in four patients. Portal vein stent were successfully implanted without any major complications. Of the 21 patients with symptoms, 17 showed improvement, and stent patency was maintained in 22 (76%) patients. The presence of a collateral vein is the only variable related to the development of an occlusion after portal stenting.
  
  
  CONCLUSIONS
  Portal vein stent were implanted safely and had good long-term patency. This procedure is useful to relieve portal hypertension-related symptoms and to improve the quality of life. Our data strongly suggest that embolization to block blood flow in a collateral vein during portal vein stent placement will improve the patency of the stent.
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. a-kato@umin.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohtsuka
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000209:etiology / Q000473:pathology / Q000601:surgery*
keywords: Hepatobiliary pancreatic surgery; Portal vein stenosis; Portal vein stent placement