Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 1;100(39):e27264.
doi: 10.1097/MD.0000000000027264.

Long term clinical outcomes of portal vein stenting for symptomatic portal vein stenosis after pancreaticoduodenectomy

Yunghun You  1 , Jin Seok Heo  2 , In Woong Han  2 , Sang Hyun Shin  2 , Sung Wook Shin  3 , Kwang Bo Park  3 , Sung Ki Cho  3 , Dongho Hyun  3
Affiliations

Long term clinical outcomes of portal vein stenting for symptomatic portal vein stenosis after pancreaticoduodenectomy

Yunghun You et al. Medicine (Baltimore). .

Abstract

Gastrointestinal bleeding caused by portal vein (PV) stenosis is serious complication after pancreaticoduodenectomy (PD) The purpose of this study is to reveal the long-term clinical outcomes of PV stenting for symptomatic PV stenosis and risk factors of stent related complication.Fifteen patients who underwent portal vein stenting for symptomatic PV stenosis after PD between 2000 and 2018 were retrospectively reviewed. The whole cohort was divided into 9 patients with benign stenosis group (Group-B) and 6 patients with recurrence group (Group-R).The median follow up period was 17.0 (interquartile range 12.0-38.0) months. The technical success rate and clinical success rate was revealed at 93.3% and 86.7%. The primary patency rate of stents was 79.4% and mean patency period was 14.0 (4.0-28.0) months. There was significant difference in time to stenosis and proportion of anticoagulation treatment between 2 groups [2.0 (1.0-4.0) months vs 18.5 (2.5-50.3) months, P = .035 and 100% vs 50%, P = .044. In univariable analysis, stent diameter was found to have a significant correlation with stent occlusion (P = .036).PV stenting was found to be feasible and safe in the treatment of symptomatic PV stenosis from a long term point of view.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
A 45-year-old male patient who underwent portal vein stenting due to recurrent hematochezia after 56 months of pylorus-preserving pancreaticoduodectomy for pancreatic cancer. (A) CT image showing varix in afferent jejunal loop (white arrow). (B) Main portal vein occlusion detected by portal venography via transhepatic approach (white arrowhead). (C) Segmental occlusion of main portal vein (short white arrows), jejunal varix connected to the right portal vein by forming a complex and extensive collateral around the afferent jejunal loop (long white arrow) and gastric varix with posterior gastric vein dilatation connected to the left portal vein (long black arrows). (D) Recanalization from SMV to MPV without jejunal collateral vessel after stenting (9 mm in diameter and 80 mm in length). (E) Improvement of varix of jejunal limb (long white arrow) confirmed on follow-up CT on the 8th day after stenting. (F) Patent stent graft shown on CT performed 78 months after stenting.
Figure 2
Figure 2
Primary patency rate of portal vein stent.
See this image and copyright information in PMC

References

    1. Yeo CJ, Sohn TA, Cameron JL, et al. . Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg 1998;227:821–31. - PMC - PubMed
    1. Uesaka K, Boku N, Fukutomi A, et al. . Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet 2016;388:248–57. - PubMed
    1. Ziegler KM, Nakeeb A, Pitt HA, et al. . Pancreatic surgery: evolution at a high-volume center. Surgery 2010;148:702–9. discussion 9-10. - PubMed
    1. Kang MJ, Jang JY, Chang YR, et al. . Portal vein patency after pancreatoduodenectomy for periampullary cancer. Br J Surg 2015;102:77–84. - PubMed
    1. Kim KR, Ko GY, Sung KB, et al. . Percutaneous transhepatic stent placement in the management of portal venous stenosis after curative surgery for pancreatic and biliary neoplasms. AJR Am J Roentgenol 2011;196:W446–50. - PubMed