Major abdominal surgeries including pancreatic resection are rarely performed in patients on chronic dialysis due to perioperative morbidity associated with end-stage renal disease. This case report presents a 71-year-old female on hemodialysis with pancreatic head cancer who underwent successful pancreaticoduodenectomy. The patient had the following severe comorbidities: type 2 diabetes mellitus, hypertension, and chronic kidney disease. Therefore, meticulous preoperative preparation, intraoperative care and postoperative management including hemodialysis and nutritional support were performed. Postoperative recovery was uneventful, bowel function was restored on day 5, and the patient was discharged in good condition. This case provides the feasibility of pancreaticoduodenectomy (also known as Whipple procedure) in carefully monitored patients, particularly those on dialysis, despite the increased risk of complications like cardiovascular, immune, and coagulation disorders. Brief literature review confirms that patients with end-stage renal disease can be considered for abdominal surgery with acceptable morbidity and mortality in complex surgical procedures.

Background: Splenic artery embolization (SAE) is commonly used in cirrhosis to manage hypersplenism and cytopenia. However, its longer-term clinical impact beyond hematologic parameters remains insufficiently characterized. Aim: To characterize longitudinal inpatient trajectories, clinical patterns, and follow-up features after SAE in patients with cirrhosis treated at a tertiary referral center in Kazakhstan. Methods: This retrospective single-center study included 149 patients with cirrhosis who underwent SAE. Clinical, laboratory, and imaging data were collected across sequential inpatient episodes. Outcomes included longitudinal patterns of hospitalization, laboratory trends, and baseline factors associated with a favorable clinical course. Subsequent hospitalization was defined as any inpatient episode following the index SAE admission, regardless of whether it was planned or unplanned. Results: During follow-up, 59.1% of patients had a second inpatient episode, with progressively fewer patients contributing to later observations. Liver disease severity remained largely stable, with no significant changes in Child–Pugh distribution. Portal hypertension manifestations, including varices and splenomegaly, remained highly prevalent, while recurrent variceal bleeding was relatively uncommon. Laboratory parameters demonstrated modest changes without sustained statistically significant improvement, and the number of recorded inpatient episodes decreased across sequential follow-up. Relatively stable documented follow-up trajectories were more frequently observed in patients with preserved liver function (Child–Pugh A), absence of ascites, and higher albumin levels. The most common causes of subsequent hospitalization were ascites and hepatic decompensation (38.9%) and varices without bleeding (26.2%), while documented major procedure-related complications were infrequent. Conclusions: In this retrospective single-center cohort, predominantly coil-based proximal or selective SAE demonstrated an acceptable documented major complication profile in selected patients with cirrhosis and portal hypertension. Because no untreated control group was available, the findings should be interpreted as descriptive real-world longitudinal data rather than causal evidence of reduced hospitalization burden.