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Preoperative trans-jugular porto-systemic shunt for oncological gastric surgery in a cirrhotic patient
Authors:Andrea Liverani;Luigi Solinas;Tatiana Di Cesare;Luca Velari;Tiziano Neri;Francesco Cilurso;Francesco Favi;Giancarlo Bizzarri;
Institution:Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, ItalyLuca Velari, Giancarlo Bizzarri, Department of Radiology, Regina Apostolorum Hospital, 00100 Rome, Italy
Abstract:Abdominal surgery in cirrhotic patients with portal hypertension is associated with high incidence ofdisease 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:Gastric cancer  Cirrhotic patients  Esophageal varices  Portal hypertension  Trans-jugular porto-systemic shunt  Gastric surgery
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