Bertrand Le Roy1, Johan Gagnière2, Pascal Chabrot3,4, Denis Pezet2, Armand Abergel5,4, Emmanuel Buc2,4. 1. Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France. leroybertrand8@gmail.com. 2. Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France. 3. Department of Vascular Radiology, Gabriel Montpied Hospital, CHU Clermont-Ferrand, Place Henri Dunant, 63000, Clermont-Ferrand, France. 4. Faculty of Medicine from Clermont-Ferrand, UMR Auvergne CNRS 6284, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France. 5. Department of Hepatology, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.
Abstract
BACKGROUND: 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. METHODS: We present here the case of a cirrhotic patient that underwent a TIPS for refractory ascites, with early complete thrombosis without lethal complication. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: 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. METHODS: We present here the case of a cirrhotic patient that underwent a TIPS for refractory ascites, with early complete thrombosis without lethal complication. RESULTS: 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. CONCLUSION: 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: Alban Denys; Celine Lacombe; Frederic Schneider; David C Madoff; Francesco Doenz; Salah D Qanadli; Nermin Halkic; Alain Sauvanet; Valerie Vilgrain; Pierre Schnyder Journal: J Vasc Interv Radiol Date: 2005-12 Impact factor: 3.464
Authors: Bertrand Le Roy; Antoine Perrey; Mikael Fontarensky; Johan Gagnière; Armand Abergel; Bruno Pereira; Celine Lambert; Louis Boyer; Denis Pezet; Pascal Chabrot; Emmanuel Buc Journal: World J Surg Date: 2017-07 Impact factor: 3.352