Treatment of extrahepatic portal hypertension in children by mesenteric-to-left portal vein bypass: a new physiological procedure
- Resource Type
- Authors
- L. Matricardi; Philippe Clapuyt; W Rigamonti; Jean-Bernard Otte; Etienne Sokal; Daniele Alberti; G Caccia; D Falchetti; J. de Ville de Goyet
- Source
- The European journal of surgery = Acta chirurgica. 165(8)
- Subject
- medicine.medical_specialty
Adolescent
Portal venous pressure
Anastomosis
Esophageal and Gastric Varices
Transplantation, Autologous
Extrahepatic portal hypertension
Mesenteric Veins
Hypertension, Portal
medicine
Humans
Superior mesenteric vein
Vein
Child
business.industry
Portal Vein
Anastomosis, Surgical
Infant
medicine.disease
Thrombosis
Surgery
Portal vein thrombosis
medicine.anatomical_structure
Treatment Outcome
Child, Preschool
Portal hypertension
Radiology
Jugular Veins
business
Gastrointestinal Hemorrhage
Follow-Up Studies
- Language
- ISSN
- 1102-4151
Objective: To achieve hepatic portal revascularisation and decompression of extrahepatic portal hypertension in children with cavernoma and obstruction caused by idiopathic portal vein thrombosis, Design: Selected cases. Setting: Teaching hospitals, Belgium and Italy. Subjects: 11 children who weighed between 5.9 and 54 kg (2 emergencies) with symptomatic extrahepatic portal hypertension. Intervention: Interposition of venous autograft between the superior mesenteric vein and the distal (umbilical) portion of the left portal vein. Main outcome measures: Improvements in symptoms and endoscopic appearance after operation. Results: 2 bypasses had to be redone because they stenosed; all 11 were patent at the time of writing (median follow-up 6 months, range 1-32 months). Conclusion: The bypass effectively relieved symptoms of extrahepatic portal hypertension by restoring normal hepatic portal blood flow.