Liverani A, Solinas L, Cesare TD, Velari L, Neri T, Cilurso F, Favi F, Bizzarri G. Preoperative trans-jugular porto-systemic shunt for oncological gastric surgery in a cirrhotic patient. World J Gastroenterol 2015; 21(3): 997-1000 [PMID: 25624736 DOI: 10.3748/wjg.v21.i3.997]
Corresponding Author of This Article
Tatiana Di Cesare, MD, Department of General Surgery, Regina Apostolorum Hospital, Via San Francesco 50, 00040 Albano Laziale (RM), 00100 Rome, Italy. tatiana.dicesare@hotmail.it
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 21, 2015; 21(3): 997-1000 Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.997
Preoperative trans-jugular porto-systemic shunt for oncological gastric surgery in a cirrhotic patient
Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Luca Velari, Tiziano Neri, Francesco Cilurso, Francesco Favi, Giancarlo Bizzarri
Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy
Luca Velari, Giancarlo Bizzarri, Department of Radiology, Regina Apostolorum Hospital, 00100 Rome, Italy
Author contributions: Liverani A designed the research and had final approval of the version to be published; Solinas L and Di Cesare T performed the research; Velari L and Bizzarri G contributed new reagents or analytic tools; Neri T and Cilurso F made substantial contributions to the conception and design; Favi F analyzed the data; Liverani A, Solinas L and Di Cesare T wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tatiana Di Cesare, MD, Department of General Surgery, Regina Apostolorum Hospital, Via San Francesco 50, 00040 Albano Laziale (RM), 00100 Rome, Italy. tatiana.dicesare@hotmail.it
Telephone: +39-6-932989 Fax: +39-6-9321138
Received: March 6, 2014 Peer-review started: March 7, 2014 First decision: April 28, 2014 Revised: May 13, 2014 Accepted: October 15, 2014 Article in press: October 15, 2014 Published online: January 21, 2015
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.
Core tip: We suggest a preoperative trans-jugular porto-systemic shunt in patients with portal hypertension and gastric cancer to perform a safer gastrectomy. This procedure decreases intraoperational blood loss and postoperative morbidity. Moreover, the normalization of portal vein pressure permits the performance of an oncological nodes dissection. Finally, this technique may reduce perioperative mortality.
