Preoperative trans-jugular porto-systemic shunt for oncological gastric surgery in a cirrhotic patient

World J Gastroenterol. 2015 Jan 21;21(3):997-1000. doi: 10.3748/wjg.v21.i3.997.

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.

Keywords: Cirrhotic patients; Esophageal varices; Gastric cancer; Gastric surgery; Portal hypertension; Trans-jugular porto-systemic shunt.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Blood Loss, Surgical / prevention & control
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / virology
  • Female
  • Gastrectomy*
  • Humans
  • Hypertension, Portal / diagnosis
  • Hypertension, Portal / physiopathology
  • Hypertension, Portal / surgery*
  • Hypertension, Portal / virology
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / virology
  • Portal Pressure
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Portography
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Color