Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2022; 14(5): 1038-1046
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.1038
Biliary obstruction following transjugular intrahepatic portosystemic shunt placement in a patient after liver transplantation: A case report
Peter Macinga, Darina Gogova, Jan Raupach, Jana Jarosova, Libor Janousek, Eva Honsova, Pavel Taimr, Julius Spicak, Jiri Novotny, Jan Peregrin, Tomas Hucl
Peter Macinga, Darina Gogova, Jana Jarosova, Pavel Taimr, Julius Spicak, Tomas Hucl, Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague 14021, Czech Republic
Jan Raupach, Department of Radiology, University Hospital, Hradec Kralove 50005, Czech Republic
Libor Janousek, Department of Transplant Surgery, Institute for Clinical and Experimental Medicine, Prague 14021, Czech Republic
Eva Honsova, Department of Pathology, Institute for Clinical and Experimental Medicine, Prague 14021, Czech Republic
Jiri Novotny, Jan Peregrin, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague 14021, Czech Republic
Author contributions: Hucl T, Peregrin J and Macinga P created the conception and design of this research; Macinga P and Hucl T wrote the paper, Gogova D and Jarosova J reviewed the literature and contributed to manuscript drafting; Raupach J performed transjugular intrahepatic portosystemic shunt placement; Janousek L performed liver transplantation and provided surgical consultations; Honsova E performed histological examination; Novotny J performed percutaneous transhepatic biliary drainage and interpreted the imaging findings; Hucl T, Spicak J, Taimr P and Peregrin J were responsible for the revision of the manuscript for important intellectual content; All authors revised the manuscript and issued final approval for the version to be submitted.
Supported by Czech Health Research Council, No. 17-30281A.
Informed consent statement: The patient provided us with consent to publish his case and all relevant imaging documentation.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have prepared and revised this manuscript according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tomas Hucl, MD, PhD, Professor, Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Videnska 1958, Prague 14021, Czech Republic. tomas.hucl@ikem.cz
Received: December 22, 2021
Peer-review started: December 22, 2021
First decision: February 15, 2022
Revised: April 24, 2022
Accepted: April 24, 2022
Article in press: April 24, 2022
Published online: May 27, 2022
Core Tip

Core Tip: Biliary stricture is the most unusual complication of transjugular intrahepatic portosystemic shunt (TIPS) implantation yet to be reported in liver transplant recipients. In our patient, TIPS was successfully used to treat the rare liver graft disease, sinusoidal obstruction syndrome. Cholangitis with abscess formation caused by a TIPS-induced stricture of the right hepatic duct was successfully treated by percutaneous and subsequent endoscopic drainage and resulted in preserved liver graft function. However, the stenosis persisted even after long-term endoscopic treatment. The outcome of our case is comparable to those reported in a native liver where no case was resolved using only biliary drainage.