Abstract
A 69-year-old man was admitted to hospital with melena and severe anemia 3 years after pancreatoduodenectomy for carcinoma of the papilla of Vater. Portogram findings showed stenosis of the portal vein and dilated collaterals from the jejunal vein. Postoperative inflammatory changes were suspected to be the source of the stenosis. Jejunal varices resulting from portal vein stenosis were suspected as the cause of melena. Therefore, expandable metallic stent placement was carried out under percutaneous transhepatic portography to maintain portal blood flow. After the procedure, there has been no recurrence during 5-year follow-up.
A 75-year-old woman was admitted to hospital with melena 18 months after pancreatoduodenectomy for pancreatic cancer. Radiologic imaging demonstrated portal vein stenosis and collateral formation, which was caused by recurrence of the cancer. Expandable metallic stent placement was carried out in the same way. The patient was asymptomatic for 16 months after the procedure, but she died 38 months after pancreatoduodenectomy.
Expandable metallic stent placement is recommended as a treatment for gastrointestinal bleeding caused by postoperative portal stenosis.
