Treatment of extrahepatic portal hypertension in children by mesenteric-to-left portal vein bypass: a new physiological procedure

• Published in: The European journal of surgery Vol. 165; no. 8; pp. 777 - 781
• Main Authors: de Ville de Goyet, J., Alberti, D., Falchetti, D., Rigamonti, W., Matricardi, L., Clapuyt, P., Sokal, E. M., Otte, J. B., Caccia, G.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: UK Taylor & Francis, Ltd 01.08.1999; Taylor & Francis
• Subjects: Adolescent; Anastomosis, Surgical - methods; Biological and medical sciences; Child; Child, Preschool; Esophageal and Gastric Varices - surgery; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Hemorrhage - surgery; Humans; Hypertension, Portal - surgery; Infant; Jugular Veins - transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Mesenteric Veins - surgery; Other diseases. Semiology; Portal Vein - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Transplantation, Autologous; Treatment Outcome; Human; Left; Portal circulation disease; Idiopathic; Cardiovascular disease; Mesentery; Obstruction; Thrombosis; Venous disease; Result; Vascular disease; Treatment; Bypass; Surgery; Surgical decompression; Cavernoma; Portal hypertension; Digestive diseases; Technique; Portal vein; Vein; Child; Revascularization
• ISSN: 1102-4151; 1741-9271
• DOI: 10.1080/11024159950189573

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. Copyright © 1999 Taylor and Francis Ltd.