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: | Jamieson, Dr Nigel and Oien, Professor Karin and Duthie, Dr Fraser and McKay, Mr Colin |
| 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 > School 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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