Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2026
Laparoscopy-assisted mesenteric vein access for portal vein recanalization and Transjugular intrahepatic portosystemic shunt: A novel TIPS approach for cavernous transformation of the portal vein.
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Dongfang Liu, Zichao Qiu, Zhendong Yue, Yu Zhang, Yifan Wu, Chengbin Dong, Qimei Li, Dezhong Wang, Haijiao Yu, Zhenhua Fan, Lei Wang
Аннотация
AIMS: To evaluate the feasibility and efficacy of Laparoscopy-Assisted mesenteric vein access for portal vein recanalization-transjugular intrahepatic portosystemic shunt (LAmTIPS) in patients with symptomatic portal hypertension and Cavernous Transformation.
METHODS: A total of five patients (5 male, mean age: 41.4 years; range, 15-63 years) with chronic portal vein thrombosis (PVT) complicated by cavernous transformation of the portal vein (CTPV) were included in this study. Transjugular intrahepatic portosystemic shunt (TIPS) could not be accomplished via the conventional splenic vein-guided or intrahepatic portal vein-guided approaches in these cases, primarily attributed to intrahepatic portal vein occlusion and splenic vein thrombosis with cavernous transformation. Consequently, LAmTIPS was performed in all the 5 cases.
RESULTS: LAmTIPS was successful in all patients at first attempt (4 cases via conventional laparoscopy, 1 case via robot-assisted laparoscopy). No immediate complication was observed following the procedures. Follow-up imaging with computed tomography (CT) scan and Doppler ultrasound revealed patent TIPS and portal venous vasculature in all patients.
CONCLUSION: LAmTIPS is a feasible approach for patients with chronic PVT complicated by CTPV.
METHODS: A total of five patients (5 male, mean age: 41.4 years; range, 15-63 years) with chronic portal vein thrombosis (PVT) complicated by cavernous transformation of the portal vein (CTPV) were included in this study. Transjugular intrahepatic portosystemic shunt (TIPS) could not be accomplished via the conventional splenic vein-guided or intrahepatic portal vein-guided approaches in these cases, primarily attributed to intrahepatic portal vein occlusion and splenic vein thrombosis with cavernous transformation. Consequently, LAmTIPS was performed in all the 5 cases.
RESULTS: LAmTIPS was successful in all patients at first attempt (4 cases via conventional laparoscopy, 1 case via robot-assisted laparoscopy). No immediate complication was observed following the procedures. Follow-up imaging with computed tomography (CT) scan and Doppler ultrasound revealed patent TIPS and portal venous vasculature in all patients.
CONCLUSION: LAmTIPS is a feasible approach for patients with chronic PVT complicated by CTPV.