Laparoscopic Cholecystectomy in a Patient with Portal Cavernoma

Feasibility of laparoscopic cholecystectomy for symptomatic gallstone disease with portal cavernoma: Can prior portal vein decompression be avoided?

“…Indications for shunt surgery in PC include recurrent bleeding or high-grade varices, symptomatic splenomegaly, symptomatic hypersplenism, or constellation of these symptoms. Patients with symptomatic PCC require prior portal decompression, not only to diminish the risk of bleeding; the shunt surgery itself alleviates biliary obstruction in two-thirds of these patients [3,[9][10][11][12][13][14]. Only a few case reports or series have reported the safety of isolated LC in PC [4,[11][12][13].…”

“…Patients with symptomatic PCC require prior portal decompression, not only to diminish the risk of bleeding; the shunt surgery itself alleviates biliary obstruction in two-thirds of these patients [3,[9][10][11][12][13][14]. Only a few case reports or series have reported the safety of isolated LC in PC [4,[11][12][13]. Our study supports the safety of LC without portal vein decompression with a conversion rate of 7%, with no mortality, minimum morbidity, and a median hospital stay of 2 days.…”

Cavernous Transformation of the Portal Vein Secondary to Cholecystolithiasis

“…Cavernous transformation of the portal vein (CTPV) among adults is quite rare, with an incidence of 15.6% among extrahepatic portal vein obstruction (EHPVO), including one-third of thrombotic portal veins,[ 1 ] and accordingly are thought to be secondary to EHPVO triggered by inflammation, adjacent tissue fibrosis, tumor invasion, pancreatitis, and clotting disorders. [ 1 2 3 ] CTPV is characterized by a series of tortuous collateral portal veins at the liver hilum, with portal vein occlusion at the level of the spinoportal conjunction. [ 2 ] In this case, it was more likely caused by chronic cholecystitis based on the original normal portal vein lumen.…”