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

Jabbar, S.A.A., Jamieson, N.B. , Morris, A.J., Oien, K.A. , Duthie, F., McKay, C.J., Carter, C.R. and Dickson, E.J. (2016) A Glasgow tipple-transjugular intrahepatic portosystemic shunt insertion prior to Whipple resection. Journal of Surgical Case Reports, 2016(5), rjw089. (doi: 10.1093/jscr/rjw089) (PMID:27177892) (PMCID:PMC4866079)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McKay, Mr Colin and Duthie, Dr Fraser and Oien, Professor Karin and Jamieson, Dr Nigel
Authors: Jabbar, S.A.A., Jamieson, N.B., Morris, A.J., Oien, K.A., Duthie, F., McKay, C.J., Carter, C.R., and Dickson, E.J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Journal of Surgical Case Reports
Publisher:Oxford University Press
ISSN:2042-8812
ISSN (Online):2042-8812
Published Online:13 May 2016
Copyright Holders:Copyright © The Author 2016
First Published:First published in Journal of Surgical Case Reports 2016(5):1-3
Publisher Policy:Reproduced under a Creative Commons License

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