Non-conventional portosystemic shunts in children with extrahepatic portal vein obstruction.
Portal hypertension due to extrahepatic portal vein obstruction is ideally treated by the use of a selective shunt. In a four year period between July 1987 and June 1992, 50 surgical procedures were carried out in 48 children with portal hypertension-related variceal hemorrhage. The portal, splenic, mesenteric, or coronary vein was not available for anastomosis in four children who, therefore, underwent non-conventional shunts which are described here. There was no postoperative mortality. One patient had a repeat gastrointestinal hemorrhage, probably due to stenosis of the shunt and failure to ligate the coronary vein. No rebleeding occurred on follow-up of at least 18 months. We conclude that in selected children requiring surgery for portal hypertension due to extrahepatic portal venous obstruction, a non-conventional shunt may be used with beneficial results.
D'Cruz
A J
AJ
Department of Pediatric Surgery, St John's Medical College Hospital, Bangalore, India.
Kamath
P S
PS
Ramachandra
C
C
Jalihal
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D008297:Male; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000379:methods*