Portal Vein Stenting for Portal Vein Stenosis after Pancreatoduodenectomy—A Report on Three Cases—

Abstract

Three patients underwent intravascular stenting for postoperative stenosis of the portal and/or superior mesenteric veins (PV/SMV) following pancreatoduodenectomy. Among these, two patients experienced postoperative pancreatic fistula, which may have caused PV/SMV stenosis. These patients experienced digestive tract bleeding from collateral vessels formed around the PV/SMV stenosis, ascites due to portal hypertension, or hyperammonemia caused by a portal-systemic shunt. All patients underwent stenting for PV/SMV stenosis using a percutaneous transhepatic approach followed by preventive antithrombotic therapy. Stent patency was confirmed in all patients at least two years after the procedure. We also confirmed the efficacy of stenting for all causes of PV/SMV stenosis following pancreatoduodenectomy by reviewing previous reports. These data support active introduction of stenting treatment when PV/SMV stenosis is encountered following pancreatoduodenectomy.