Intrahepatic Shunt Porto Systemic via Transjugular (TIPS) Indication Prior to Gastric Esophagus Surgery: A Case Report

Marcelo Zamorano1*, Juan Carlos Díaz2, Patricio Palavecino3, Nasser Eluzen1, Tomás Cermenati3, Jorge Arancibia-Radich4, Rafaella V. Zárate1 and Duxan Arancibia1*

1Unidad de Cirugía. Departamento de Ciencias Médicas. Facultad de Medicina y Odontología. Universidad de Antofagasta.
2Departamento de Cirugía. Hospital Clínico de la Universidad de Chile.
3Departamento de Radiología Intervencional. Hospital Clínico de la Universidad de Chile.
4Departamento de Biología. Facultad de Química y Biología. Universidad Santiago de Chile.

^*Correspondance to: Marcelo Zamorano Díaz 

 PDF  Full Text DOI: 10.25107/2474-1647.3438

Abstract

More than 10% of cirrhotic patients will require surgeries during the last two years of life. Among the causes of morbidity and mortality, most are derived from portal hypertension. The Transjugular Intrahepatic Portosystemic Shunt (TIPS) has been used before abdominal surgeries to reduce portal hypertension, including the Gastroesophageal Junction (GEJ), the most common site of collateral circulation. The case of a patient with portal hypertension and esophageal-gastric varices who underwent installation of TIPS as a bridge therapy to total gastrectomy is presented. The results show a reduction of esophagogastric varices, allowing esophagojejunal anastomosis to be performed without bleeding and in tissue not damaged by endoscopic ligatures. A TIP has a role as temporary therapy for patients awaiting liver transplantation to prevent and treat variceal bleeding. Several series have successfully described the use of TIPS prior to abdominal surgeries, reducing the risk of bleeding and mortality. This report postulates the use of TIPS prior to surgeries involving EGJ. However, despite the favorable results, more experience and larger cohorts are required to estimate the proper performance of this therapy accurately.

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Cite the article

Zamorano M, Díaz JC, Palavecino P, Eluzen N, Cermenati T, Radich JA, et al. Intrahepatic Shunt Porto Systemic via Transjugular (TIPS) Indication Prior to Gastric Esophagus Surgery: A Case Report. Clin Surg. 2022; 7: 3438..