Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2024; 16(4): 1195-1202
Published online Apr 27, 2024. doi: 10.4240/wjgs.v16.i4.1195
Percutaneous transhepatic stenting for acute superior mesenteric vein stenosis after pancreaticoduodenectomy with portal vein reconstruction: A case report
Chen Lin, Zi-Yan Wang, Liang-Bo Dong, Zhi-Wei Wang, Ze-Hui Li, Wei-Bin Wang
Chen Lin, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Zi-Yan Wang, Liang-Bo Dong, Ze-Hui Li, Wei-Bin Wang, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China
Zhi-Wei Wang, Interventional Section, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
Co-first authors: Chen Lin and Zi-Yan Wang.
Author contributions: Lin C and Wang WB designed the study; Lin C and Wang ZY collected the data and wrote the paper; Wang ZY performed the data analysis; Lin C, Dong LB, and Wang WB performed the surgery; Wang ZW performed the percutaneous transhepatic stent placement; Dong LB and Li ZH were the surgical residents of the patient.
Supported by the National Natural Science Foundation of China, No. 82173074; the Beijing Natural Science Foundation, No. 7232127; the National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-D-001 and No. 2022-PUMCH-B-004; the CAMS Innovation Fund for Medical Sciences, No. 2021-I2M-1-002; the Nonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences, No. 2018PT32014; and Fundamental Research Funds for the Central Universities, No. 3332019025.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Wei-Bin Wang, MD, Chief Doctor, Department of General Surgery, Peking Union Medical College Hospital, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
Received: December 25, 2023
Peer-review started: December 25, 2023
First decision: January 11, 2024
Revised: January 24, 2024
Accepted: March 19, 2024
Article in press: March 19, 2024
Published online: April 27, 2024

Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein (PV)/superior mesenteric veins (SMV) stenosis/occlusion. It has been widely used after liver transplantation surgery; however, reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.


Herein, we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery. The patient was successfully treated using stent grafts. Although the stenosis resolved after stent placement, complications, including bleeding, pancreatic fistula, bile leakage, and infection, made the treatment highly challenging. The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding. After careful treatment, the patient stabilized, and stent placement effectively managed postoperative PV/SMV stenosis.


Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.

Keywords: Pancreaticoduodenectomy, Portal vein reconstruction, Portal vein stenosis, Portal vein stent, Case report

Core Tip: Portal vein (PV)/superior mesenteric veins (SMV) stenosis/occlusion is an uncommon but severe complication after pancreatic surgery. Stent placement for acute PV/SMV stenosis within 3 d postoperatively was rarely reported. We reported a case showing that percutaneous transhepatic stent placement was an effective and feasible treatment for acute SMV stenosis on postoperative day 2 after the Whipple procedure and could relieve patients’ symptoms. Complications after SMV stent placement, such as bleeding, infection, pancreatic fistula and bile leakage should be fully noticed and carefully managed, especially when considering their interactive effects. Anticoagulation was initiated for preventing stent thrombosis, but it increased risk of bleeding.