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Alternative treatment for gallbladder stones in portal venous thrombosis
Authors:Penteado Sonia  Machado Marcel C  Cunha José Eduardo M  Jukemura Jose  Montagnini André L  Bacchella Telesforo
Affiliation:Gastrointestinal Surgery, Division of Biliopancreatic Surgery, University of S. Paulo Medical School, S. Paulo, Brazil. viasbiliares.pancreas@hcnet.usp.br
Abstract:BACKGROUND/AIMS: Cholecystectomy for treatment of gallbladder stones in patients with portal vein thrombosis can be a hazardous procedure. Dissection into an area of thin-walled collateral vessels can trigger troublesome bleeding and consequent blood coagulation disorders. METHODOLOGY: In order to avoid dissection, cholecysto-jejunostomy was used as the treatment of choice in three patients with symptomatic gallbladder stones and portal vein thrombosis. RESULTS: Surgical procedure was uneventful, blood or plasma transfusions were not required either at surgery or afterwards. Pre- and postoperative hematocrit evaluations showed no difference, as well as liver function tests. The procedure was well tolerated and patients were discharged from day 5 to 7. Follow-up ranged from 2 to 3 years, no biliary complications were found during this period. CONCLUSIONS: Choleysto-jejunostomy is a safe procedure and can be used as an effective treatment of symptomatic gallbladder stones in patients with portal vein thrombosis.
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