Balloon-occlusion technique for managing portal vein hemorrhage in liver transplantation

John B. Seal, Humberto Bohorquez, Naren Battula, Lucia DeGregorio, Emily Bugeaud, David S. Bruce, Ian C. Carmody, Ari J. Cohen, George E. Loss

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. Case Report: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction. This alternative mode of bleeding control optimizes exposure to the retropancreatic space and avoids direct application of vascular clamps that can cause further injury to the vessel and surrounding tissue. Conclusion: Careful preoperative planning and anticipation of potential problems are essential for safe and effective management of complex PVT intraoperatively. The balloon-occlusion technique can facilitate safe and efficient repair of a portal vein injury during TEV for liver transplantation.

Original languageEnglish (US)
Pages (from-to)76-79
Number of pages4
JournalOchsner Journal
Volume17
Issue number1
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Keywords

  • Endovascular procedures
  • Liver transplantation
  • Portal vein
  • Reconstructive surgical procedures
  • Venous thrombosis

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Seal, J. B., Bohorquez, H., Battula, N., DeGregorio, L., Bugeaud, E., Bruce, D. S., Carmody, I. C., Cohen, A. J., & Loss, G. E. (2017). Balloon-occlusion technique for managing portal vein hemorrhage in liver transplantation. Ochsner Journal, 17(1), 76-79. https://doi.org/10.1043/1524-5012-17.1.76