The transjugular stent implantation for the treatment of malignant portal and hepatic vein obstruction in cancer patients

Background: The increase in portal vascular resistance is asignificant complication of metastatic disease to the liver or locallyadvanced cancer, e.g., biliary cancer.Patients and methods: This paper describes the successful palliativetreatment of two cancer patients with portal hypertension presenting with thesymptoms of tense ascites, mesenteric congestion, and severe varicealbleeding. By creating a stent-tract between a hepatic vein and a main branchof the portal vein and/or by placing an extendable stent into the portal vein,the transjugular intrahepatic portosystemic stent-shunt (TIPS) technique wasused to decompress the portovascular system.Results: The TIPS-technique offers a new, safe and effectivepalliation for malignant portal hypertension. In both patients, the symptomsof the portal hypertension disappeared after the procedure. This wasaccompanied by a significant improvement of the patients performance status,allowing an early ambulation.Conclusion: Our findings demonstrate the feasibility andeffectiveness of the TIPS procedure as a minimal invasive treatment for portalvein decompression in selected tumor patients.