Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.997
Peer-review started: March 7, 2014
First decision: April 28, 2014
Revised: May 13, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: January 21, 2015
Processing time: 320 Days and 4.5 Hours
Abdominal surgery in cirrhotic patients with portal hypertension is associated with high incidence of disease and mortality. In these patients, oncological gastric procedures with lymph-nodes dissection show much higher complication rates than in normotensive portal vein patients. Thus, normalization of portal vein pressure may be a favorable determinant factor to reduce complications. We report a case of a patient with hepatitis C virus-related hepatic cirrhosis, esophageal varices, portal hypertension and gastric cancer. We demonstrated the efficacy of a preoperative trans-jugular porto-systemic shunt to perform oncological radical resection more safely. We retained preoperative the trans-jugular porto-systemic shunt in the patients with elevated portal pressure and gastric cancer to perform a gastrectomy more safely and to decrease morbidity and mortality of these cases.
Core tip: We suggest a preoperative trans-jugular porto-systemic shunt in patients with portal hypertension and gastric cancer to perform a safer gastrectomy. This procedure decreases intraoperational blood loss and postoperative morbidity. Moreover, the normalization of portal vein pressure permits the performance of an oncological nodes dissection. Finally, this technique may reduce perioperative mortality.