Skip to main content


Log in

Endovascular balloon occlusion during reconstruction of portal vein injury

  • How-I-Do-It articles
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript



Repair of portal vein injury in a hostile abdomen can be very challenging, complicated by massive hemorrhage or stenosis. It can seldom be successfully carried out, even by experienced hepatobiliary surgeons. The ideal venous clamping technique is often not feasible and increases the risk of lethal portal vein laceration. The common mistake being the forceful use of clamps around the vein in the attempt to obtain vascular control, resulting in additional injuries.


We provide a descriptive report of two cases detailing a careful step-by-step technique for the management of portal vein injury by inserting an endovascular balloon inflated with serum to control bleeding and repair the vein.


In patients who required this technique, no bleeding recurrence, nor portal vein thrombosis or stenosis was detected by CT-scan during follow-up.


The endovascular balloon occlusion technique for the reconstruction of portal vein injuries in hostile abdomen is a safe and life-saving procedure that should be part of the armamentarium of visceral surgeons.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others





Computed tomography


Superior mesenteric vein


  1. Fingerhut A, Leppaniemi AK, Androulakis GA, Archodovassilis F, Bouillon B, Cavina E, Chaloner E, Chiarugi M, Davidovic L, Delgado-Millan MA et al (2002) The European experience with vascular injuries. Surg Clin North Am 82(1):175–188

    Article  Google Scholar 

  2. Oderich GS, Panneton JM, Hofer J, Bower TC, Cherry KJ Jr, Sullivan T, Noel AA, Kalra M, Gloviczki P (2004) Iatrogenic operative injuries of abdominal and pelvic veins: a potentially lethal complication. J Vasc Surg 39(5):931–936

    Article  Google Scholar 

  3. Fraga GP, Bansal V, Fortlage D, Coimbra R (2009) A 20-year experience with portal and superior mesenteric venous injuries: has anything changed? Eur J Vasc Endovasc Surg 37(1):87–91

    Article  CAS  Google Scholar 

  4. Coimbra R, Filho AR, Nesser RA, Rasslan S (2004) Outcome from traumatic injury of the portal and superior mesenteric veins. Vasc Endovasc Surg 38(3):249–255

    Article  Google Scholar 

  5. Pearl J, Chao A, Kennedy S, Paul B, Rhee P (2004) Traumatic injuries to the portal vein: case study. J Trauma 56(4):779–782

    Article  Google Scholar 

  6. Cikrit DF, Dalsing MC, Sawchuk AP, Lalka SG, Harl MJ, Goulet RJ, Madura JA, Canal DF (1993) Vascular injuries during pancreatobiliary surgery. Am Surg 59(10):692–696 discussion 697

    CAS  PubMed  Google Scholar 

  7. Graham JM, Mattox KL, Beall AC Jr (1978) Portal venous system injuries. J Trauma 18(6):419–422

    Article  CAS  Google Scholar 

  8. Schrock T, Blaisdell FW, Mathewson C Jr (1968) Management of blunt trauma to the liver and hepatic veins. Arch Surg 96(5):698–704

    Article  CAS  Google Scholar 

  9. Singh G, Nahm CB, Jamieson NB, Chua TC, Wong S, Thoo C, Mittal A, Gill AJ, Samra JS (2019) Management of post-pancreatectomy haemorrhage using resuscitative endovascular balloon occlusion of the aorta. Langenbeck's Arch Surg 404(2):253–255

    Article  Google Scholar 

  10. Seal JB, Bohorquez H, Battula N, DeGregorio L, Bugeaud E, Bruce DS, Carmody IC, Cohen AJ, Loss GE (2017) Balloon-occlusion technique for managing portal vein hemorrhage in liver transplantation. Ochsner J 17(1):76–79

    PubMed  PubMed Central  Google Scholar 

  11. Aydin C, Ersan V, Baskiran A, Unal B, Kayaalp C, Yilmaz S (2014) Controlling massive hemorrhage from the retropancreatic portal vein as a complication of thromboendovenectomy during liver transplantation with balloon catheter tamponade: how to do it. Surg Today 44(4):792–794

    Article  Google Scholar 

Download references


We thank Jacqueline Butterworth for manuscript editing.

Author information

Authors and Affiliations



All authors declare having sufficiently participated in the work to take public responsibility for appropriate portions of the content, as defined in the guidelines of the International Committee of Medical Journal Editors (ICMJE). A.H., R.S., F.P., and F.N. were responsible for study concept and design and contributed to acquisition and interpretation of data. A.H. and R.S. drafted the manuscript. F.P. and F.N. contributed to critical revision. All the authors have viewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Regis Souche.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and later amendments or comparable ethical standards. For retrospective studies in France, ethical approval is not systematically required. In our department, all patients signed a non-opposition form for the use of their specimen/clinical data.

Informed consent

A non-opposition form was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Herrero, A., Souche, R., Panaro, F. et al. Endovascular balloon occlusion during reconstruction of portal vein injury. Langenbecks Arch Surg 405, 391–395 (2020).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: