2018 Volume 38 Issue 6 Pages 1059-1064
A 70-year-old man underwent a pancreaticoduodenectomy for distal bile duct cancer. At 23 months postoperatively, local recurrence was suspected around the pancreatojejunostomy site, and chemoradiation therapy was started. At 27 months postoperatively, he was admitted to the hospital with intestinal bleeding. After a detailed examination, hemorrhagic varices at the hepaticojejunostomy site associated with hepatopetal collateral vessels and portal vein stenosis were diagnosed. Although endoscopic hemostasis was repeatedly performed, intestinal bleeding from the varices could not be controlled. Therefore, the patient was repeatedly admitted. Percutaneous transhepatic portal vein stent insertion was considered for the portal vein stenosis. After embolizing the varices, including those associated with the hepatopetal collateral vessels, a portal vein stent was inserted. At 42 months after portal stent insertion, the stent was patent, and the patient was doing well without recurrence. Portal vein stent insertion can be considered to be an effective therapeutic strategy for malignant as well as benign portal vein stenosis with severe collateral symptoms.
