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Introduction <p>Biopsy is required for pancreatic cancer prior to chemotherapy. In some patients, biopsy is not feasible, because there is no safe window for either percutaneous or endoscopic ultrasound (EUS)-guided biopsy.</p> Case report <p>In a 72-year-old male patient with obstruction of the portomesenteric venous confluence due to a tumour of the pancreatic head, repeat EUS-guided biopsy attempts of the tumour remained inconclusive. The patient underwent transjugular portosystemic shunt with portal vein recanalization (PVR-TIPS) followed by transportal endovascular biopsy using a gastroscope biopsy forceps, confirming pancreatic ductal adenocarcinoma. Interventional treatment was completed by transjugular portal vein stenting for the management of ascites and bowel oedema.</p> Conclusion <p>Endovascular transportal biopsy is a feasible method for obtaining a histopathological diagnosis in pancreatic head tumours, even after failed EUS-guided biopsy.</p>

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Transportal endovascular biopsy prior to portal vein stenting in pancreatic cancer

  • 期刊论文

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  • 发表日期：

    2026年7月17日

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  • Andreas H. Mahnken

摘要

Introduction

Biopsy is required for pancreatic cancer prior to chemotherapy. In some patients, biopsy is not feasible, because there is no safe window for either percutaneous or endoscopic ultrasound (EUS)-guided biopsy.

Case report

In a 72-year-old male patient with obstruction of the portomesenteric venous confluence due to a tumour of the pancreatic head, repeat EUS-guided biopsy attempts of the tumour remained inconclusive. The patient underwent transjugular portosystemic shunt with portal vein recanalization (PVR-TIPS) followed by transportal endovascular biopsy using a gastroscope biopsy forceps, confirming pancreatic ductal adenocarcinoma. Interventional treatment was completed by transjugular portal vein stenting for the management of ascites and bowel oedema.

Conclusion

Endovascular transportal biopsy is a feasible method for obtaining a histopathological diagnosis in pancreatic head tumours, even after failed EUS-guided biopsy.