Relief of biliary obstruction due to portal vein cavernoma using a transjugular intrahepatic portosystemic shunt (TIPS) without the need for long-term stenting

Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

“…Our study suggested the following: (1) TIPS creation by combination with a transhepatic or transsplenic approach was feasible and safe in the presence of portal cavernoma, but TIPS was not recommended in the patients with a total fibrotic cord and without a large collateral vein or in those with extensive superior mesenteric vein thrombosis; (2) successful TIPS insertions could decrease the portosystemic pressure gradient and the incidence of variceal rebleeding; and (3) the Until now, only one case series has focused on assessing the outcome of TIPS in non-cirrhotic patients with portal cavernoma [9]. In other available studies, heterogeneous cases with and without liver cirrhosis and with and without portal cavernoma are included (Table 4) [10][11][12][13][14][15]. In the study by Fanelli et al, TIPS was successfully created in 92% (11/12) of patients [9].…”

“…However, the presence of portal cavernoma is regarded as a contraindication to TIPS due to the technical difficulty and potential procedure-related complications [7,8]. Additionally, given the rarity of this disease in the absence of liver cirrhosis and malignancy, the experiences on the applications of TIPS procedure are very limited in a few case reports and series [9][10][11][12][13][14][15]. Herein, we reported the results of a single-center case series to evaluate the feasibility, safety, and efficacy of TIPS for the treatment of symptomatic portal hypertension in noncirrhotic patients with portal cavernoma.…”

Therapeutic approaches for portal biliopathy: A systematic review

“…In a case report, a 45-years-old woman affected by cholestatic jaundice due to compression on CBD by extrahepatic portal and splenic vein thrombosis with collateral, was treated with TIPS: in order to decompress the biliary tree before the procedure, a biliary stent was placed and the day after TIPS was successfully performed. The biliary stent was removed after 1 wk and, at 14 mo follow-up, the patient was asymptomatic and MR/MRCP showed a significant improvement of biliary alterations and of cavernoma size[60]. Another case report described resolution of cholangiographic CBD abnormalities and normalization of LFTs after TIPS performed in a patient with PB and portal hypertension secondary to PVT[61].…”

Endoscopic Treatment of Portal Hypertensive Biliopathy: Intervene with Caution!

“…15 Transjugular intrahepatic portosystemic shunt (TIPS) have been used for reduction of compression caused by portal cavernoma. 16 Liver transplantation is indicated for decompensated secondary biliary cirrhosis.…”