Abstract:
We report 2 cases of portal vein stent placement for malignant portal stenosis due to recurrence of pancreatic cancer with symptoms of portal hypertension. Case 1: The patient was a 68-year-old female. Five years ago, a mass was found around the aorta on a computerized tomography(CT)scan taken after a residual pancreatectomy for pancreatic cancer. It was diagnosed as lymph node recurrence and S-1 therapy was started. As further tumor enlargement led to portal vein compression, venostasis around the ascending jejunum, anemia, and black stools, a portal vein stent was placed. The portal vein blood flow was improved, the collateral vessels disappeared, and the patient no longer experienced anemia or black stool. Case 2: A 75-year-old female patient underwent a subtotal gastric-sparing pancreaticoduodenectomy and combined resection of the portal vein for pancreas head cancer. On a postoperative CT scan taken 6 months later, a mass compressing the portal vein appeared, which was diagnosed as a local recurrence. As thrombocytopenia was observed, a portal vein stent was placed before starting chemotherapy. The portal vein blood flow and the platelet count improved. Portal vein stenting is an effective procedure for malignant portal stenosis, improving portal blood flow and clinical symptoms.
摘要:
我们报告2例门静脉支架置入术治疗因胰腺癌复发伴门静脉高压症所致的恶性门静脉狭窄。病例1:患者为68岁女性。五年前,在胰腺癌的残余胰腺切除术后进行的计算机断层扫描(CT)扫描中,发现主动脉周围有肿块。诊断为淋巴结复发,开始S-1治疗。随着肿瘤进一步扩大导致门静脉受压,上升的空肠周围的静脉淤积,贫血,和黑色的凳子,放置门静脉支架.门静脉血流得到改善,侧支血管消失了,患者不再出现贫血或黑便。病例2:一名75岁的女性患者因胰头癌接受了保胃胰十二指肠切除术和门静脉联合切除术。在6个月后的术后CT扫描中,出现了一个压迫门静脉的肿块,被诊断为局部复发。由于观察到血小板减少症,在开始化疗前放置门静脉支架.门静脉血流和血小板计数改善。门静脉支架置入术是治疗恶性门静脉狭窄的有效方法,改善门静脉血流和临床症状。