Restoration of portal vein flow by splenorenal shunt ligation and splenectomy after living-related liver transplantation

We describe here a case of living-related liver transplantation with a spontaneous splenorenal shunt. On the third postoperative day, Doppler ultrasound follow-up revealed impairment of intrahepatic portal vein flow and reoperation was performed. Intraoperatively, simple compression of the collatera...

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Bibliographic Details
Published inHepato-gastroenterology Vol. 48; no. 41; p. 1453
Main Authors Cescon, M, Sugawara, Y, Kaneko, J, Ohtsuka, H, Takayama, T, Makuuchi, M
Format Journal Article
LanguageEnglish
Published Greece 01.09.2001
Subjects
Adult
Blood Flow Velocity - physiology
Carcinoma, Hepatocellular - surgery
Collateral Circulation - physiology
Female
Humans
Liver Neoplasms - surgery
Liver Transplantation
Living Donors
Portal Vein - diagnostic imaging
Postoperative Complications - diagnostic imaging
Postoperative Complications - surgery
Reoperation
Splenectomy
Splenic Vein - diagnostic imaging
Splenic Vein - surgery
Ultrasonography, Doppler
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Summary:We describe here a case of living-related liver transplantation with a spontaneous splenorenal shunt. On the third postoperative day, Doppler ultrasound follow-up revealed impairment of intrahepatic portal vein flow and reoperation was performed. Intraoperatively, simple compression of the collateral veins forming the splenorenal shunt resulted in an immediate change in the portal flow pattern, which suggested the absence of a portal thrombus. Splenectomy and ligature of the more dilated collateral veins were carried out and satisfactory portal flow was restored. Although the role of splenectomy was controversial, splenectomy provided an increased portal vein flow in the present case. The uneventful postoperative course validated our decision.
ISSN:0172-6390