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Non-lethal Right Liver Atrophy After TIPS Occlusion in A Cirrhotic Patient: Introducing The Hepatic Biembolization

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Journal of Gastrointestinal Surgery

Abstract

Background

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard procedure in the treatment of refractory ascites and variceal bleeding in the setting of portal hypertension. Secondary obstruction of the shunt is a classic but potentially lethal complication.

Methods

We present here the case of a cirrhotic patient that underwent a TIPS for refractory ascites, with early complete thrombosis without lethal complication.

Results

Obstruction of the TIPS led to thrombosis of both the right hepatic and the right portal veins with progressive total atrophy of the right liver and marked hypertrophy of the left liver. Despite initial poor liver function, biological hepatic markers improved slowly until complete recovery.

Conclusion

Hence, we suggest the concept of combined right portal and hepatic vein embolization as a new procedure to induce partial liver hypertrophy before major liver resection, even in cirrhotic patients.

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Authors and Affiliations

  1. Department of Digestive and Hepatobiliary Surgery, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France

    Bertrand Le Roy, Johan Gagnière, Denis Pezet & Emmanuel Buc

  2. Department of Vascular Radiology, Gabriel Montpied Hospital, CHU Clermont-Ferrand, Place Henri Dunant, 63000, Clermont-Ferrand, France

    Pascal Chabrot

  3. Department of Hepatology, Estaing Hospital, CHU Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France

    Armand Abergel

  4. Faculty of Medicine from Clermont-Ferrand, UMR Auvergne CNRS 6284, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France

    Pascal Chabrot, Armand Abergel & Emmanuel Buc

Authors
  1. Bertrand Le Roy
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  2. Johan Gagnière
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  3. Pascal Chabrot
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  4. Denis Pezet
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  5. Armand Abergel
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  6. Emmanuel Buc
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Corresponding author

Correspondence to Bertrand Le Roy.

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Le Roy, B., Gagnière, J., Chabrot, P. et al. Non-lethal Right Liver Atrophy After TIPS Occlusion in A Cirrhotic Patient: Introducing The Hepatic Biembolization. J Gastrointest Surg 20, 1671–1672 (2016). https://doi.org/10.1007/s11605-016-3133-z

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  • DOI: https://doi.org/10.1007/s11605-016-3133-z

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