Two Cases of Esophageal Cancer with Portal Hypertension Treated with Esophagectomy with Venous Shunt Procedure

Kenji Kikuchi, Shunichi Okushiba¹⁾, Shuuji Kitashiro¹⁾, You Kawarada¹⁾, Toshiaki Shichinohe, Yuhei Yamamoto²⁾, Yoshito Komatsu³⁾, Toshiaki Morikawa, Hiroyuki Kato¹⁾ and Satoshi Kondo

Department of Surgical Oncology, Hokkaido University
Tonan Hospital¹⁾
Department of Plastic Surgery²⁾ and Department of Medical Oncology³⁾, Hokkaido University

Some 4-6% of esophageal cancer patients have liver cirrhosis, and the incidence of complication after esophageal cancer surgery in portal hypertension due to liver cirrhosis is high. One serious complication is anastomotic leakage due to congestion of venous flow in the early postoperative course. We conducted a venous shunt in addition to reconstruction of the esophagus after esophagectomy using the gastric tube in two cases of esophageal cancer with portal hypertension to avoid congestion in the gastric tube. In Case 1, a patient with portal hypertension due to liver cirrhosis had esophageal cancer type-III. After esophagectomy, we anastomosed the left gastric vein and the anterior jugular vein. In Case 2, a patient with portal hypertension due to chronic hepatitis had esophageal cancer type-II. After esophagectomy, we anastomosed the left gastric vein and the internal mammary vein. After anastomosis in both cases, we confirmed disappearance of congestion in the gastric tube. Short-term postoperative course are uneventful without serious complications such as anastomotic leakage.

Key words
venous shunt, esophageal cancer, portal hypertension

Reprint requests
Kenji Kikuchi Department of Surgical Oncology, Hokkaido University
N-14 W-5 Kita-ku, Sapporo, 060-8648 JAPAN

Accepted
July 27, 2005

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