Functional side-to-side splenorenal shunts to treat extrahepatic portal vein thrombosis in children.

Autor: Yang AY; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Slatnick BL; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Durgin J; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Truche P; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA., Kim HB; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Cuenca AG; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: alex.cuenca@childrens.harvard.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2022 Jul; Vol. 224 (1 Pt B), pp. 530-534. Date of Electronic Publication: 2022 Feb 09.
DOI: 10.1016/j.amjsurg.2022.01.031
Abstrakt: Background: Surgical shunts are commonly used to manage complications resulting from extrahepatic portal vein thrombosis (EHPVT) in children. We describe a single-center experience utilizing a functional Side-to-Side Splenorenal Shunt (fSRS), created using either an enlarged inferior mesenteric vein (IMV) or left adrenal vein (LAV).
Methods: Pediatric patients with isolated EHPVT who were poor candidates for a Rex shunt and who underwent a fSRS procedure at our institution between 2003 and 2020 were reviewed. The pre/post shunt portosystemic gradient change, rates of early and late complications, postoperative shunt patency, and mortality were evaluated.
Results: Twelve EHPVT patients (mean age of 6.1 years) underwent a fSRS procedure. The mean portosystemic gradient change for the cohort was -11.7 mmHg (±4.9). There were no cases of recurrent variceal bleeding or episodes of shunt thrombosis reported after fSRS procedures.
Conclusions: Surgical shunts continue to be an important adjunct in the treatment of complications related to EHPVT. The functional Side-to-Side Splenorenal Shunt is a safe alternative that is easy to perform, involves minimal dissection and requires only a single anastomosis.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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