title: Treatment of extrahepatic portal hypertension in children by mesenteric-to-left portal vein bypass: a new physiological procedure.
abstract: OBJECTIVE
  To achieve hepatic portal revascularisation and decompression of extrahepatic portal hypertension in children with cavernoma and obstruction caused by idiopathic portal vein thrombosis.
  
  
  METHODS
  Selected cases.
  
  
  METHODS
  Teaching hospitals. Belgium and Italy.
  
  
  METHODS
  11 children who weighed between 5.9 and 54 kg (2 emergencies) with symptomatic extrahepatic portal hypertension.
  
  
  METHODS
  Interposition of venous autograft between the superior mesenteric vein and the distal (umbilical) portion of the left portal vein.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  The bypass effectively relieved symptoms of extrahepatic portal hypertension by restoring normal hepatic portal blood flow.
authors.affiliation: Liver Unit, Birmingham Children's Hospital, UK.
authors.forename: J
authors.initials: J
authors.lastname: de Ville de Goyet
authors.forename: D
authors.initials: D
authors.lastname: Alberti
authors.forename: D
authors.initials: D
authors.lastname: Falchetti
authors.forename: W
authors.initials: W
authors.lastname: Rigamonti
authors.forename: L
authors.initials: L
authors.lastname: Matricardi
authors.forename: P
authors.initials: P
authors.lastname: Clapuyt
authors.forename: E M
authors.initials: EM
authors.lastname: Sokal
authors.forename: J B
authors.initials: JB
authors.lastname: Otte
authors.forename: G
authors.initials: G
authors.lastname: Caccia
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D007223:Infant; D007601:Jugular Veins / Q000637:transplantation; D008642:Mesenteric Veins / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome