A Glasgow Tipple-transjugular intrahepatic portosystemic shunt insertion prior to Whipple resection

被引:5
作者
Jabbar, Salman A. A. [1 ]
Jamieson, Nigel B. [1 ,2 ]
Morris, Andrew J. [3 ]
Oien, Karin A. [4 ]
Duthie, Fraser [4 ]
McKay, Colin J. [1 ]
Carter, Christopher R. [1 ]
Dickson, Euan J. [1 ]
机构
[1] Glasgow Royal Infirm, West Scotland Pancreat Unit, Glasgow G31 2ER, Lanark, Scotland
[2] Univ Glasgow, Glasgow Royal Infirm, Coll Med Vet & Life Sci, Acad Dept Surg, Glasgow G31 2ER, Lanark, Scotland
[3] Glasgow Royal Infirm, Dept Gastroenterol, Glasgow G31 2ER, Lanark, Scotland
[4] Queen Elizabeth Univ Hosp, Dept Pathol, Glasgow, Lanark, Scotland
来源
JOURNAL OF SURGICAL CASE REPORTS | 2016年 / 05期
关键词
D O I
10.1093/jscr/rjw089
中图分类号
R61 [外科手术学];
学科分类号
摘要
Abdominal surgery performed in patients with significant liver disease and portal hypertension is associated with high mortality rates, with even poorer outcomes associated with complex pancreaticobiliary operations. We report on a patient requiring portal decompression via transjugular intrahepatic portosystemic shunt (TIPS) prior to a pancreaticoduodenectomy. The 49-year-old patient presented with pain, jaundice and weight loss. At ERCP an edematous ampulla was biopsied, revealing high-grade dysplasia within a distal bile duct adenoma. Liver biopsy was performed to investigate portal hypertension, confirming congenital hepatic fibrosis (CHF). A TIPS was performed to enable a pancreaticoduodenectomy. Prophylactic TIPS can be performed for preoperative portal decompression for patients requiring pancreatic resection. A potentially curative resection was performed when abdominal surgery was initially thought impossible. Notably, CHF has been associated with the development of cholangiocarcinoma in only four previous instances, with this case being only the second reported distal bile duct cholangiocarcinoma.
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