• hepatocellular carcinoma;
  • portal vein thrombosis;
  • portal stent;
  • cirrhotic;
  • metallic stent;
  • macroscopic portal vein invasion;
  • tumoral thrombus;
  • cirrhosis


Background and Aims

Macroscopic portal vein invasion complicating hepatocellular carcinoma in the setting of cirrhosis is associated with a very low survival. To prevent the malignant progression from a portal branch to the main portal trunk, we have placed noncovered metallic stents extending from the portal trunk to the contralateral tumor free portal pedicle.


Fifty-Four patients (age: 60 ± 11 years) were treated. Thirty-four (60%) patients were Child A and 20 (40%) were Child B–C. Tumoral thrombosis involved 1st or 2nd order branches in 41 (82%) patients and partially the main trunk in 13 (24%). Open surgical insertion (via ileal vein) as an alternative to a percutaneous approach was used in 14 (24%) patients.


Early mortality (<30 days) was 7%. Following stent insertion, a transarterial chemoembolization was performed in 26 (48%) patients. After stenting, overall survival at 6, 12, and 24 months were 47%, 44%, and 36%, respectively. Bilirubin > 30 µmol/L and open surgical insertion were predictive of short-term mortality. In the good group, overall survival at 6, 12, and 24 months were 69%, 61%, and 46%, respectively.


The transhepatic deployment of metallic stent seems to improve survival of patients with hepatocellular carcinoma complicated by portal vein tumoral thrombosis and could allow subsequent treatments. J. Surg. Oncol. 2013;107:696–701. © 2012 Wiley Periodicals, Inc.